MEDICARE: MRS. SHARON JUDITH MALONEY MA, LPC/MHSP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101Y00000X	Counselor	2817	TN

General Provider Information

NPI Number	:	1265788533
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SHARON JUDITH MALONEY MA, LPC/MHSP

Provider Business Mailing Address
First Line	:	335 11TH ST NE
Second Line	:
City	:	CLEVELAND
State	:	TN
Zip	:	37311-5104
Country	:	US
Telephone Number	:	423-476-5513
Fax Number	:	423-664-5715

Provider Business Practice Location Address
First Line	:	335 11TH ST NE
Second Line	:
City	:	CLEVELAND
State	:	TN
Zip	:	37311-5104
Country	:	US
Telephone Number	:	423-476-5513
Fax Number	:	423-664-5715

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/24/2012
Last Update Date	:	07/24/2012

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