Provider Demographics
NPI:1548327752
Name:MALONEY, CAROL A (MSW)
Entity type:Individual
Prefix:
First Name:CAROL
Middle Name:A
Last Name:MALONEY
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1011 SANDUSKY ST STE N
Mailing Address - Street 2:
Mailing Address - City:PERRYSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43551-3171
Mailing Address - Country:US
Mailing Address - Phone:419-873-0096
Mailing Address - Fax:
Practice Address - Street 1:1011 SANDUSKY ST STE N
Practice Address - Street 2:
Practice Address - City:PERRYSBURG
Practice Address - State:OH
Practice Address - Zip Code:43551-3171
Practice Address - Country:US
Practice Address - Phone:419-873-0096
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI00024461041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical