MEDICARE: THE MISSING PEACE CONSULTING & FAMILY COUNSELING, INC.

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	103K00000X	Behavior Analyst
2	106H00000X	Marriage & Family Therapist

General Provider Information

NPI Number	:	1417810250
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE MISSING PEACE CONSULTING & FAMILY COUNSELING, INC.

Provider Business Mailing Address
First Line	:	6330 FOUNTAIN SQUARE DR UNIT 4422
Second Line	:
City	:	CITRUS HEIGHTS
State	:	CA
Zip	:	95611-5155
Country	:	US
Telephone Number	:	916-628-4802
Fax Number	:

Provider Business Practice Location Address
First Line	:	6330 FOUNTAIN SQUARE DR UNIT 4422
Second Line	:
City	:	CITRUS HEIGHTS
State	:	CA
Zip	:	95611-5155
Country	:	US
Telephone Number	:	916-628-4802
Fax Number	:

Authorized Official
Title or Position	:	CO-OWNER
Name	:	DR. JACQUELYN MARIE MALOY
Credential	:	PH.D.
Telephone Number	:	916-628-4802

Provider Enumeration Date	:	12/08/2025
Last Update Date	:	12/08/2025

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