Provider Demographics
NPI:1720744907
Name:MALIK, MASHAL (LSW)
Entity Type:Individual
Prefix:
First Name:MASHAL
Middle Name:
Last Name:MALIK
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2321 FRELINGHUYSEN WAY
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:NJ
Mailing Address - Zip Code:08873-7546
Mailing Address - Country:US
Mailing Address - Phone:732-877-8888
Mailing Address - Fax:
Practice Address - Street 1:2321 FRELINGHUYSEN WAY
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:NJ
Practice Address - Zip Code:08873-7546
Practice Address - Country:US
Practice Address - Phone:732-877-8888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-12
Last Update Date:2021-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL065442001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical