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General NPI Number Information
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NPI Number | 1831892520
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Entity Type | Individual
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Provider Name | NASHUA CHARLES ARCOLEO MALKO LCSW, LICSW
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Gender | Male
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Dates
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Enumeration Date | 03/23/2023
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Last Update Date | 05/30/2025
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Provider Practice Location Address
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Address Line | 3430 MOUNTAIN RD
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City | STOWE
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State | VT
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Zip | 05672-4800
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Country | US
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Telephone | 518-563-8000
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Fax |
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Provider Business Mailing Address
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Address Line | 473 S PROSPECT ST APT 2
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City | BURLINGTON
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State | VT
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Zip | 05401-3566
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Country | US
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Telephone | 732-421-4802
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 097.0136134
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License Number State | VT
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 156.0134175
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License Number State | VT
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Taxonomy #3
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 113468
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License Number State | NY
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Taxonomy #4
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 099963
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License Number State | NY
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Taxonomy #5
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 089.0136535
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License Number State | VT
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