Stacy Malm, LCPC

Primary specialty

CounselorTaxonomy code 101Y00000X

Practice address

3401 N Central Ave
Chicago, IL 60634-4426

Phone

(773) 286-8822

Fax

(773) 824-4997

NPI assigned

May 17, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196294400000",
    "number": "1104878008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3401 N CENTRAL AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606344426",
            "telephone_number": "773-286-8822",
            "fax_number": "773-824-4997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 N CENTRAL AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606344426",
            "telephone_number": "773-286-8822",
            "fax_number": "773-824-4997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALM",
        "first_name": "STACY",
        "credential": "LCPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-17",
        "last_updated": "2007-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC#",
            "identifier": "01635515",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kelly Malloy
• Phillip J Malloy, PT
• Riley Shannon Malloy, MS
• Jennifer Mally, LCPC
• Eric Christopher Malm, LCSW
• Casey Malman
• Alyse Malmborg, MA
• Meghan Malmquist, BCAT, RBT, B.S. B.A.
• Dana Malo
• Marco Malo Jr.

• Counselor in Chicago, IL
• Providers in Chicago, IL by specialty
• Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.