Provider Demographics
NPI:1710858170
Name:MALACAPAY, MARK CAMION (LCSW)
Entity type:Individual
Prefix:MR
First Name:MARK
Middle Name:CAMION
Last Name:MALACAPAY
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:153 ERASMUS ST APT 3A
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11226-8573
Mailing Address - Country:US
Mailing Address - Phone:646-269-5115
Mailing Address - Fax:
Practice Address - Street 1:153 ERASMUS ST APT 3A
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11226-8573
Practice Address - Country:US
Practice Address - Phone:646-269-5115
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-17
Last Update Date:2025-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1004671041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty