Provider Demographics
NPI:1861516999
Name:MALONE, EVELYN R (LPC, LMFT, CEAP)
Entity type:Individual
Prefix:MRS
First Name:EVELYN
Middle Name:R
Last Name:MALONE
Suffix:
Gender:F
Credentials:LPC, LMFT, CEAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11702B GRANT RD.
Mailing Address - Street 2:SUITE 422
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77429
Mailing Address - Country:US
Mailing Address - Phone:832-618-5156
Mailing Address - Fax:866-330-3497
Practice Address - Street 1:12515 KLUGE RD
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77429-2414
Practice Address - Country:US
Practice Address - Phone:832-618-5156
Practice Address - Fax:866-330-3497
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-16
Last Update Date:2013-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2126101YP2500X
TX003728-042796106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional