Provider Demographics
NPI:1972228120
Name:MALONE, NANCY (LCSW)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:
Last Name:MALONE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:206 BELLE ARBOR DR
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08034-1803
Mailing Address - Country:US
Mailing Address - Phone:856-287-7104
Mailing Address - Fax:
Practice Address - Street 1:85 CRESCENT AVE
Practice Address - Street 2:
Practice Address - City:PASSAIC
Practice Address - State:NJ
Practice Address - Zip Code:07055-2437
Practice Address - Country:US
Practice Address - Phone:973-931-2276
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-10
Last Update Date:2022-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC059808001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical