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NPI Code Detail

MEDICARE: KAYLA R MALLOY MA, LMHC

MEDICARE: KAYLA R MALLOY MA, LMHC
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
1101YM0800XMental Health Counselor005045NY

General Provider Information

NPI Number : 1306273958
Entity Type Code : Individual
Provider Name (Legal Business Name) : KAYLA R MALLOY MA, LMHC
Provider Business Mailing Address
First Line : 391 WESTERN AVE
Second Line :
City : ALBANY
State : NY
Zip : 12203-1401
Country : US
Telephone Number : 518-242-4731
Fax Number :
Provider Business Practice Location Address
First Line : 391 WESTERN AVE
Second Line :
City : ALBANY
State : NY
Zip : 12203-1401
Country : US
Telephone Number : 518-242-4731
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/27/2013
Last Update Date : 09/27/2013

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