Provider Demographics
NPI:1962538272
Name:MALY, MICHAEL O (LPCC)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:O
Last Name:MALY
Suffix:
Gender:M
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3101 HILLSIDE ROAD
Mailing Address - Street 2:
Mailing Address - City:SEVEN HILLS
Mailing Address - State:OH
Mailing Address - Zip Code:44131-4538
Mailing Address - Country:US
Mailing Address - Phone:216-671-4508
Mailing Address - Fax:844-852-5988
Practice Address - Street 1:3101 HILLSIDE ROAD
Practice Address - Street 2:
Practice Address - City:SEVEN HILLS
Practice Address - State:OH
Practice Address - Zip Code:44131-4538
Practice Address - Country:US
Practice Address - Phone:216-671-4508
Practice Address - Fax:844-852-5988
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-23
Last Update Date:2024-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE1102101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health