Provider Demographics
NPI:1134597883
Name:CALIP-MALONE, JILLIAN (LPC)
Entity type:Individual
Prefix:
First Name:JILLIAN
Middle Name:
Last Name:CALIP-MALONE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:204 W MCDERMOTT DR STE A
Mailing Address - Street 2:
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75013-8058
Mailing Address - Country:US
Mailing Address - Phone:214-413-9347
Mailing Address - Fax:
Practice Address - Street 1:600 E TAYLOR ST
Practice Address - Street 2:SUITE 4011
Practice Address - City:SHERMAN
Practice Address - State:TX
Practice Address - Zip Code:75090
Practice Address - Country:US
Practice Address - Phone:903-893-0298
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-11
Last Update Date:2018-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX69407101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional