Provider Demographics
NPI:1376040568
Name:JANELLE MALOCH LLC
Entity type:Organization
Organization Name:JANELLE MALOCH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:JANELLE
Authorized Official - Middle Name:K
Authorized Official - Last Name:MALOCH
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:412-807-8975
Mailing Address - Street 1:5908 BRYANT ST STE 5
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15206-1606
Mailing Address - Country:US
Mailing Address - Phone:570-885-4492
Mailing Address - Fax:
Practice Address - Street 1:5908 BRYANT ST STE 5
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15206-1606
Practice Address - Country:US
Practice Address - Phone:412-807-8975
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-12
Last Update Date:2018-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS018370261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)