MEDICARE: JESSICA MALONEY LPC, LCDC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YA0400X	Addiction (Substance Use Disorder) Counselor	12020	TX
2	101YM0800X	Mental Health Counselor	94821	TX

General Provider Information

NPI Number	:	1932538022
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSICA MALONEY LPC, LCDC

Provider Business Mailing Address
First Line	:	1914 SKILLMAN ST STE 110-188
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75206-8559
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1914 SKILLMAN ST STE 110-188
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75206-8559
Country	:	US
Telephone Number	:	214-244-0495
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/08/2013
Last Update Date	:	04/19/2026

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