Provider Demographics
NPI:1871736553
Name:MALSKY, KATHLEEN FRANCES (LCSW)
Entity type:Individual
Prefix:MS
First Name:KATHLEEN
Middle Name:FRANCES
Last Name:MALSKY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:34 MANORVIEW WAY
Mailing Address - Street 2:
Mailing Address - City:MANORVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11949
Mailing Address - Country:US
Mailing Address - Phone:631-514-5790
Mailing Address - Fax:631-801-2501
Practice Address - Street 1:250 MONTAUK HWY.
Practice Address - Street 2:
Practice Address - City:EAST MORICHES
Practice Address - State:NY
Practice Address - Zip Code:11940
Practice Address - Country:US
Practice Address - Phone:631-514-5790
Practice Address - Fax:631-801-2501
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-11
Last Update Date:2023-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY082688-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical