Michael David Malloy | Brentwood, TN • PECOS Search

Michael David Malloy

Social Worker

Behavioral Health & Social Service Providers

7101 Executive Center Dr Bldg 5, Suite 290, Brentwood, TN 37027-5236

PECOS Enrollment

Based on the most recent information from CMS, provider Michael David Malloy does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records yesterday at 11:54 AM.

Profile Details

Provider ID
1396881843
Provider Type
Individual
Full Name
Malloy, Michael David
Title
Mr.
Credential
LCSW

Gender
Male
Sole Proprietor
Yes
Enumeration Date
1/30/2007
Last Updated
7/8/2007

Contact Information

Practice Location

7101 Executive Center Dr Bldg 5, Suite 290, Brentwood, TN 37027-5236

Unlisted Fax

Mailing Location

PO Box 3574, Brentwood, TN 37024-3574

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 1041C0700X Primary	Description Social Worker Behavioral Health & Social Service Providers	License LSW 3136 Tennessee