MEDICARE: MS. SAKIERA DENISE MALONE LCSW-C

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	LICDC.162718	OH
2	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1972350577
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SAKIERA DENISE MALONE LCSW-C

Provider Business Mailing Address
First Line	:	1747 OLENTANGY RIVER RD # 1018
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43212-1453
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1747 OLENTANGY RIVER RD # 1018
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43212-1453
Country	:	US
Telephone Number	:	614-356-7788
Fax Number	:

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

Provider Enumeration Date	:	05/01/2024
Last Update Date	:	11/04/2024

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