Provider Demographics
NPI:1699252445
Name:MALONEY, ERIN (MSW, LCSW)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:MALONEY
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5501 CONNECTICUT ST
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63139-1701
Mailing Address - Country:US
Mailing Address - Phone:314-629-4059
Mailing Address - Fax:
Practice Address - Street 1:412 S CLAY AVE
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63122-5860
Practice Address - Country:US
Practice Address - Phone:314-599-4336
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-24
Last Update Date:2018-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20110308771041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical