Provider Demographics
NPI:1124188784
Name:MALBON, BRIAN (MSW)
Entity type:Individual
Prefix:
First Name:BRIAN
Middle Name:
Last Name:MALBON
Suffix:
Gender:
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 THIRD ST APT 201
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:NH
Mailing Address - Zip Code:03820-3584
Mailing Address - Country:US
Mailing Address - Phone:603-988-6240
Mailing Address - Fax:
Practice Address - Street 1:15 THIRD ST APT 201
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:NH
Practice Address - Zip Code:03820-3584
Practice Address - Country:US
Practice Address - Phone:603-988-6240
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-12
Last Update Date:2025-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH24831041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical