Basic Information
| Provider Information | |||||||||
| NPI: | 1477874808 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MALEC | ||||||||
| FirstName: | JENNIFER | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | MSW, LCSW, CCS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5525 RESEARCH PARK DR FL 4 | ||||||||
| Address2: | |||||||||
| City: | CATONSVILLE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 212284873 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9738313540 | ||||||||
| FaxNumber: | 9738313503 | ||||||||
| Practice Location | |||||||||
| Address1: | 1 CEDAR CREST VILLAGE DR | ||||||||
| Address2: | |||||||||
| City: | POMPTON PLAINS | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 074442100 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9738313540 | ||||||||
| FaxNumber: | 9738313503 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/21/2010 | ||||||||
| LastUpdateDate: | 04/23/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | 44SC05478800 | NJ | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.