MEDICARE: B.L. MALONE & ASSOCIATES, INC.

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	1041C0700X	Clinical Social Worker	0772B	AL
2	106H00000X	Marriage & Family Therapist	21	AL

General Provider Information

NPI Number	:	1962831792
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	B.L. MALONE & ASSOCIATES, INC.

Provider Business Mailing Address
First Line	:	114 W 10TH ST STE D
Second Line	:
City	:	ANNISTON
State	:	AL
Zip	:	36201-5614
Country	:	US
Telephone Number	:	256-770-7339
Fax Number	:	256-770-7338

Provider Business Practice Location Address
First Line	:	114 W 10TH ST STE D
Second Line	:
City	:	ANNISTON
State	:	AL
Zip	:	36201-5614
Country	:	US
Telephone Number	:	256-770-7339
Fax Number	:	256-770-7338

Authorized Official
Title or Position	:	OWNER
Name	:	MR. BOBBY MALONE
Credential	:	LMFT, ACSW
Telephone Number	:	256-770-7339

Provider Enumeration Date	:	11/02/2013
Last Update Date	:	11/02/2013

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