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NPI Code Detail

MEDICARE: DR. MICHAEL PATRICK MALONE PSY.D

MEDICARE:  DR. MICHAEL PATRICK MALONE  PSY.D
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
1101YM0800XMental Health CounselorLC2181MD
2101YA0400XAddiction (Substance Use Disorder) Counselor
3103T00000XPsychologist05394MD

General Provider Information

NPI Number : 1952480725
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MICHAEL PATRICK MALONE PSY.D
Provider Business Mailing Address
First Line : 3355 SAINT JOHNS LN STE J
Second Line :
City : ELLICOTT CITY
State : MD
Zip : 21042-2600
Country : US
Telephone Number : 240-547-9462
Fax Number : 240-319-7339
Provider Business Practice Location Address
First Line : 3355 SAINT JOHNS LN STE J
Second Line :
City : ELLICOTT CITY
State : MD
Zip : 21042-2600
Country : US
Telephone Number : 240-547-9462
Fax Number : 240-319-7339
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/03/2006
Last Update Date : 04/18/2024

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