Individual
ELLEN L.H. MALONE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LISW, LCSW, ACSW
Contact information
Practice address
1408 HIGHWAY 90, SUITE 2, GAUTIER, MS 39553-5456
(228) 497-8180
(228) 497-6594
Mailing address
PO BOX 1512, GAUTIER, MS 39553-0019
(228) 497-8180
(228) 497-6594
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
C2571
MS
1041C0700X
Clinical Social Worker
I-0003297
OH
1041C0700X
Clinical Social Worker
LSW0000001199
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00802799
—
MS
Enumeration date
06/16/2005
Last updated
08/29/2011
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