Provider Demographics
NPI:1194097618
Name:MALONEY, ALLISON MEREDITH (PHD, LCSW-R)
Entity type:Individual
Prefix:DR
First Name:ALLISON
Middle Name:MEREDITH
Last Name:MALONEY
Suffix:
Gender:F
Credentials:PHD, LCSW-R
Other - Prefix:
Other - First Name:ALLISON
Other - Middle Name:MEREDITH
Other - Last Name:BERGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CSW
Mailing Address - Street 1:30 LINDBERGH ST
Mailing Address - Street 2:
Mailing Address - City:GARDEN CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11530-6611
Mailing Address - Country:US
Mailing Address - Phone:516-578-3575
Mailing Address - Fax:
Practice Address - Street 1:30 LINDBERGH ST
Practice Address - Street 2:
Practice Address - City:GARDEN CITY
Practice Address - State:NY
Practice Address - Zip Code:11530-6611
Practice Address - Country:US
Practice Address - Phone:516-578-3575
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-30
Last Update Date:2012-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR049053-11041C0700X
NY019829-1103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical