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NPI Code Detail

MEDICARE: GENEVIEVE MALTBY LCSW

MEDICARE:   GENEVIEVE  MALTBY  LCSW
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
11041C0700XClinical Social Worker
2104100000XSocial Worker149.021953IL
3104100000XSocial Worker150-102991IL

General Provider Information

NPI Number : 1649813452
Entity Type Code : Individual
Provider Name (Legal Business Name) : GENEVIEVE MALTBY LCSW
Provider Business Mailing Address
First Line : 617 CAMLIN AVE
Second Line :
City : ROCKFORD
State : IL
Zip : 61103-4715
Country : US
Telephone Number : 815-871-2410
Fax Number :
Provider Business Practice Location Address
First Line : 631 N LONGWOOD ST STE 103
Second Line :
City : ROCKFORD
State : IL
Zip : 61107-4263
Country : US
Telephone Number : 815-962-5585
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/24/2019
Last Update Date : 05/30/2025

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Directions to “ GENEVIEVE MALTBY LCSW” Practice Location

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