Individual
ALAN MALCHUK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSW, LCSW
Contact information
Practice address
4217 LAKE CLIFF DR, CLEMMONS, NC 27012-8409
(336) 712-2828
Mailing address
4217 LAKE CLIFF DR, CLEMMONS, NC 27012-8409
(336) 712-2828
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
C002865
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C002865
NC SOCIAL WORK CERTIFICATION AND LICENSURE BOARD
NC
Enumeration date
04/12/2021
Last updated
04/12/2021
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