Healthcare Provider Details

I. General information

NPI: 1952575607
Provider Name (Legal Business Name): CLINICAL & FORENSIC PSYCHOLOGICAL SERVICES, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/14/2008
Last Update Date: 04/14/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

38 MILDRED AVE
ASHEVILLE NC
28806-3116
US

IV. Provider business mailing address

PO BOX 1661
ASHEVILLE NC
28802-1661
US

V. Phone/Fax

Practice location:
  • Phone: 828-226-1730
  • Fax:
Mailing address:
  • Phone: 828-226-1730
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number3429
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code103TH0100X
TaxonomyHealth Service Psychologist
License Number3429
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code103TP2701X
TaxonomyGroup Psychotherapy Psychologist
License Number3429
License Number StateNC
# 4
Primary TaxonomyY
Taxonomy Code103TF0200X
TaxonomyForensic Psychologist
License Number3429
License Number StateNC

VIII. Authorized Official

Name: DR. L. ALVIN MALESKY JR.
Title or Position: PRESIDENT
Credential: PH.D.
Phone: 828-226-1730