Healthcare Provider Details

I. General information

NPI: 1932016557
Provider Name (Legal Business Name): AMELIA MALONE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/27/2026
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10465 MELODY DR STE 226
NORTHGLENN CO
80234-4120
US

IV. Provider business mailing address

7035 W 120TH AVE APT 32
BROOMFIELD CO
80020-2347
US

V. Phone/Fax

Practice location:
  • Phone: 314-637-6007
  • Fax:
Mailing address:
  • Phone: 314-637-6007
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberLSW.0009927432
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: