Provider Demographics
NPI:1871378216
Name:MALONEY, NATHANIEL (LPC)
Entity type:Individual
Prefix:
First Name:NATHANIEL
Middle Name:
Last Name:MALONEY
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20000 HORIZON WAY STE 120
Mailing Address - Street 2:
Mailing Address - City:MOUNT LAUREL
Mailing Address - State:NJ
Mailing Address - Zip Code:08054-4303
Mailing Address - Country:US
Mailing Address - Phone:856-269-0019
Mailing Address - Fax:
Practice Address - Street 1:20000 HORIZON WAY STE 120
Practice Address - Street 2:
Practice Address - City:MOUNT LAUREL
Practice Address - State:NJ
Practice Address - Zip Code:08054-4303
Practice Address - Country:US
Practice Address - Phone:856-269-0019
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-25
Last Update Date:2024-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00622300101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional