Healthcare Provider Details

I. General information

NPI: 1316420110
Provider Name (Legal Business Name): STEPHEN VINCENT MALONEY LICSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/08/2018
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

940 BELMONT ST BLDG 7
BROCKTON MA
02301-5596
US

IV. Provider business mailing address

36 INDIAN PATH RD
HALIFAX MA
02338-1302
US

V. Phone/Fax

Practice location:
  • Phone: 774-826-2942
  • Fax: 774-826-3177
Mailing address:
  • Phone: 774-226-5954
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number122445
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number122445
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: