Provider Demographics
NPI:1811057722
Name:MALOY, WILLIAM VICTOR (LPC)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:VICTOR
Last Name:MALOY
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 BREMO RD
Mailing Address - Street 2:STE. 105
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23226-2440
Mailing Address - Country:US
Mailing Address - Phone:804-282-8332
Mailing Address - Fax:804-288-4558
Practice Address - Street 1:2000 BREMO RD
Practice Address - Street 2:STE. 105
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23226-2440
Practice Address - Country:US
Practice Address - Phone:804-282-8332
Practice Address - Fax:804-288-4558
Is Sole Proprietor?:No
Enumeration Date:2006-12-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VALPC0701001782101Y00000X
VALMFT07170000740106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101Y00000XBehavioral Health & Social Service ProvidersCounselor
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA54-0353-7Medicaid