Provider Demographics
NPI:1891900825
Name:MALAIN, ROBERT DALY (MA)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:DALY
Last Name:MALAIN
Suffix:
Gender:M
Credentials:MA
Other - Prefix:MR
Other - First Name:ROBERT
Other - Middle Name:DALY
Other - Last Name:MALAIN
Other - Suffix:II
Other - Last Name Type:Other Name
Other - Credentials:MA
Mailing Address - Street 1:819 WATER ST
Mailing Address - Street 2:SUITE 300
Mailing Address - City:KERRVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78028-5333
Mailing Address - Country:US
Mailing Address - Phone:830-258-5430
Mailing Address - Fax:830-792-5771
Practice Address - Street 1:819 WATER ST
Practice Address - Street 2:SUITE 300
Practice Address - City:KERRVILLE
Practice Address - State:TX
Practice Address - Zip Code:78028-5333
Practice Address - Country:US
Practice Address - Phone:830-258-5430
Practice Address - Fax:830-792-5771
Is Sole Proprietor?:No
Enumeration Date:2007-05-12
Last Update Date:2010-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13358101YP2500X
TX004770106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX026944102OtherINTEGRATED MENTAL HEALTH
TX026944102Medicaid
TX2036661OtherCIGNA
TX234258OtherUNITED BEHAVIORAL HEALTH
TX264687OtherPHCS PRIV HEALTHCARE SYS
TX0007300122OtherAETNA
TX13358OtherLPC LICENSE
TX234258OtherUNITED HEALTHCARE
TX611420032OtherMAIL HANDLERS BENEFIT PL
TX611420032OtherCORPHEALTH
TX162141OtherVALUE OPTIONS PROVIDER #
TX243259000OtherMAGELLAN BEHAVIORAL HEALT
TX026944102OtherTEXAS CHIP
TX611420032OtherMHNET
TX0007300122OtherAETNA BEHAVIORAL HEALTH
TX026944102OtherTEJAS BEHAVIORAL HEALTH
TX611420032OtherGUARDIAN INSURANCE CO
TX6270LCOtherBLUE CROSS BLUE SHIELD
TXA870423OtherVALUE OPTIONS VENDOR #
TX2036661OtherCIGNA BEHAVIORAL HEALTH
TX611420032OtherAMD HEALTH PLAN