Provider Demographics
NPI:1972812824
Name:MALPASS, HOWARD G JR (MAC, LPCS)
Entity type:Individual
Prefix:MR
First Name:HOWARD
Middle Name:G
Last Name:MALPASS
Suffix:JR
Gender:M
Credentials:MAC, LPCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:510 E CAROLINA AVE
Mailing Address - Street 2:
Mailing Address - City:HARTSVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29550-4312
Mailing Address - Country:US
Mailing Address - Phone:803-920-8186
Mailing Address - Fax:803-212-4275
Practice Address - Street 1:510 E CAROLINA AVE
Practice Address - Street 2:
Practice Address - City:HARTSVILLE
Practice Address - State:SC
Practice Address - Zip Code:29550-4312
Practice Address - Country:US
Practice Address - Phone:803-920-8186
Practice Address - Fax:803-212-4275
Is Sole Proprietor?:No
Enumeration Date:2010-09-27
Last Update Date:2010-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC64091101YA0400X
SC5053101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional