MEDICARE: PATRICK RAYMOND MALONEY LCSW, CACIII

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	101YA0400X	Addiction (Substance Use Disorder) Counselor	3090	CO
2	1041C0700X	Clinical Social Worker	991004	CO

General Provider Information

NPI Number	:	1417058736
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PATRICK RAYMOND MALONEY LCSW, CACIII

Provider Business Mailing Address
First Line	:	5931 MIDDLEFIELD RD
Second Line	:	SUITE 103
City	:	LITTLETON
State	:	CO
Zip	:	80123-2862
Country	:	US
Telephone Number	:	720-981-3480
Fax Number	:	720-981-3464

Provider Business Practice Location Address
First Line	:	9200 W CROSS DR STE 510
Second Line	:
City	:	LITTLETON
State	:	CO
Zip	:	80123-0761
Country	:	US
Telephone Number	:	720-981-3480
Fax Number	:

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

Provider Enumeration Date	:	09/26/2006
Last Update Date	:	04/25/2023

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