Provider Demographics
NPI:1861433492
Name:MALAFRONTE, ROBERT R (LCSW)
Entity type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:R
Last Name:MALAFRONTE
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 1:553 PORTLAND COBALT RD
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:CT
Mailing Address - Zip Code:06480-1968
Mailing Address - Country:US
Mailing Address - Phone:860-342-0760
Mailing Address - Fax:860-342-4226
Practice Address - Street 1:553 PORTLAND COBALT RD
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:CT
Practice Address - Zip Code:06480-1968
Practice Address - Country:US
Practice Address - Phone:860-342-0760
Practice Address - Fax:860-342-4226
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0027191041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical