Provider Demographics
NPI:1831738442
Name:MALASKY, REBECCA SUE (LMSW)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:SUE
Last Name:MALASKY
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1988 SHERLYNN DR
Mailing Address - Street 2:
Mailing Address - City:BRIGHTON
Mailing Address - State:MI
Mailing Address - Zip Code:48114-7618
Mailing Address - Country:US
Mailing Address - Phone:248-933-9217
Mailing Address - Fax:
Practice Address - Street 1:1988 SHERLYNN DR
Practice Address - Street 2:
Practice Address - City:BRIGHTON
Practice Address - State:MI
Practice Address - Zip Code:48114-7618
Practice Address - Country:US
Practice Address - Phone:248-933-9217
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-30
Last Update Date:2022-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801093930104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker