Provider Demographics
NPI:1619607694
Name:MALONEY, TESSA (LPCC)
Entity type:Individual
Prefix:
First Name:TESSA
Middle Name:
Last Name:MALONEY
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2985 GOLDEN OAK DR
Mailing Address - Street 2:
Mailing Address - City:HILLIARD
Mailing Address - State:OH
Mailing Address - Zip Code:43026-7983
Mailing Address - Country:US
Mailing Address - Phone:330-442-6873
Mailing Address - Fax:
Practice Address - Street 1:150 E WILSON BRIDGE RD STE 220
Practice Address - Street 2:
Practice Address - City:WORTHINGTON
Practice Address - State:OH
Practice Address - Zip Code:43085-6302
Practice Address - Country:US
Practice Address - Phone:614-526-9846
Practice Address - Fax:614-215-9866
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-13
Last Update Date:2024-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE.2404555101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health