Provider Demographics
NPI:1336219013
Name:MALONEY, JULIET J (LCSW-R)
Entity Type:Individual
Prefix:
First Name:JULIET
Middle Name:J
Last Name:MALONEY
Suffix:
Gender:F
Credentials:LCSW-R
Other - Prefix:
Other - First Name:JULIET
Other - Middle Name:J
Other - Last Name:FLORIAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:5500 MAIN ST
Mailing Address - Street 2:STE 262
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-6746
Mailing Address - Country:US
Mailing Address - Phone:716-207-8804
Mailing Address - Fax:716-616-0895
Practice Address - Street 1:5500 MAIN ST
Practice Address - Street 2:STE 262
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-6746
Practice Address - Country:US
Practice Address - Phone:716-207-8804
Practice Address - Fax:716-616-0895
Is Sole Proprietor?:No
Enumeration Date:2006-11-09
Last Update Date:2021-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY072862104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00671792Medicaid
NY00671792Medicaid
NYP26380Medicare UPIN