Healthcare Provider Details

I. General information

NPI: 1871400507
Provider Name (Legal Business Name): LEE MALONY LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/26/2026
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

618 E 8TH ST
ANDERSON IN
46012-4019
US

IV. Provider business mailing address

17381 FERRIS ST APT 312
NOBLESVILLE IN
46060-8330
US

V. Phone/Fax

Practice location:
  • Phone: 317-207-2118
  • Fax:
Mailing address:
  • Phone: 317-207-2118
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number33010126A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: