Michael Patrick Malone, PSY.D

Primary specialty

PsychologistTaxonomy code 103T00000X

License

05394 Issued in MD

Practice address

3355 Saint Johns LN Ste J
Ellicott City, MD 21042-2600

Phone

(240) 547-9462

Fax

(240) 319-7339

NPI assigned

Nov 3, 2006

Last updated

Apr 18, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Jan 1, 2017 through Jan 1, 2027

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Excellis Consulting and Clinical Services, LLC

  • Counselor
  • Columbia, MD
  • NPI 1184042616
  NPD (past) Authorized official

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

{
    "created_epoch": "1162512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713398400000",
    "number": "1952480725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3355 SAINT JOHNS LN STE J",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210422600",
            "telephone_number": "240-547-9462",
            "fax_number": "240-319-7339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3355 SAINT JOHNS LN STE J",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210422600",
            "telephone_number": "240-547-9462",
            "fax_number": "240-319-7339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALONE",
        "first_name": "MICHAEL",
        "middle_name": "PATRICK",
        "name_prefix": "Dr.",
        "credential": "PSY.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-03",
        "last_updated": "2024-04-18",
        "certification_date": "2024-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MD",
            "license": "LC2181",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MD",
            "license": "05394",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paige Majd, PHARMD
• Rodel Maglanque Malabanan, PT
• Leila Marie Malavite, D.AC., L.AC.
• Kristina Maleski, PTA
• Jacqueline Elizabeth Mallon
• Jemie Gonzales Manago, PT
• Wana Manitpisitkul, PHARM.D.
• Amy Manner, MA, CAS, NCSP
• Julia Brooke Manning
• Shirley Marc

• Psychologist in Ellicott City, MD
• Providers in Ellicott City, MD by specialty
• Psychologist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.