| Kathleen Kelly Malone, Lcsw Llc | |
|
1 Dell Lane Ardsley NY 10502 | |
| (914) 450-7695 | |
| (914) 693-4175 |
| Full Name | Kathleen Kelly Malone, Lcsw Llc |
|---|---|
| Speciality | Social Worker |
| Location | 1 Dell Lane, Ardsley, New York |
| Authorized Official Name and Position | Kathleen Kelly Malone (OWNER) |
| Authorized Official Contact | 9144507695 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kathleen Kelly Malone, Lcsw Llc 1 Dell Lane Ardsley NY 10502 Ph: (914) 450-7695 | Kathleen Kelly Malone, Lcsw Llc 1 Dell Lane Ardsley NY 10502 Ph: (914) 450-7695 |
| NPI Number | 1457717506 |
|---|---|
| Provider Enumeration Date | 01/05/2016 |
| Last Update Date | 01/07/2016 |
| Medicare PECOS PAC ID | 0345548087 |
|---|---|
| Medicare Enrollment ID | O20160414000042 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457717506 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | R-028357-1 (New York) | Primary |
| Provider Name | Kathleen K Malone |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1760403174 PECOS PAC ID: 3173699238 Enrollment ID: I20080915000181 |
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