Active NPI
Loren A Malkasian, M.A.; LMHC
- Marriage & Family Therapist
- Surfside Beach, SC
National Provider Identifier
1649277740
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 4711
- Practice address
- 1500 Highway 17 N Ste 201
Surfside Beach, SC 29575-6078 - Phone
- (508) 254-0066
- NPI assigned
- Jul 5, 2005
- Last updated
- Apr 11, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | LMHC 4564 | MA | |
| Marriage & Family Therapist | 106H00000X | 4711 | SC | Primary |
Addresses
Primary practice location
1500 Highway 17 N Ste 201
Surfside Beach, SC 29575-6078
Mailing address
502 Lumber St
Nichols, SC 29581-5074
Phone (508) 254-0066
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1890727 | Medicaid | MA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LMHC 4564 | MA | MD | Mental Health Counselor |
| 4711 | SC | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Crystal Clear Counseling | Mental Health | Current | Accepting new patients |
Locations
1500 Highway 17 N
Ste 201
Surfside Beach, SC 29575
Phone (508) 254-0066
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Mental Health Counselor
- Surfside Beach, SC
- NPI 1184481194
-
- Professional Counselor
- Murrells Inlet, SC
- NPI 1629424551
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1120521600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1712793600000",
"number": "1649277740",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "502 LUMBER ST",
"city": "NICHOLS",
"state": "SC",
"postal_code": "295815074",
"telephone_number": "508-254-0066"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1500 HIGHWAY 17 N STE 201",
"city": "SURFSIDE BEACH",
"state": "SC",
"postal_code": "295756078",
"telephone_number": "508-254-0066"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MALKASIAN",
"first_name": "LOREN",
"middle_name": "A",
"name_prefix": "Ms.",
"credential": "M.A.; LMHC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-07-05",
"last_updated": "2024-04-11",
"certification_date": "2024-04-11",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "MA",
"license": "LMHC 4564",
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "SC",
"license": "4711",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1890727",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Surfside Beach, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.