Provider Demographics
NPI:1871936401
Name:MALECK, SARAH (LPC, LMFT)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:MALECK
Suffix:
Gender:F
Credentials:LPC, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 RAY O VAC DR STE 320
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53711-2471
Mailing Address - Country:US
Mailing Address - Phone:608-203-6267
Mailing Address - Fax:
Practice Address - Street 1:700 RAY O VAC DR STE 320
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53711-2471
Practice Address - Country:US
Practice Address - Phone:608-514-1625
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-13
Last Update Date:2022-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1445-226101YM0800X
WI977-124101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI977-124OtherLMFT
WI5370-125OtherLPC