Provider Demographics
NPI:1922202134
Name:MALESKI, STANLEY STEVE (ED D)
Entity type:Individual
Prefix:DR
First Name:STANLEY
Middle Name:STEVE
Last Name:MALESKI
Suffix:
Gender:M
Credentials:ED D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4901 GOLDEN OAKS DR
Mailing Address - Street 2:
Mailing Address - City:OAK RIDGE
Mailing Address - State:NC
Mailing Address - Zip Code:27310-9844
Mailing Address - Country:US
Mailing Address - Phone:336-392-2170
Mailing Address - Fax:
Practice Address - Street 1:4901 GOLDEN OAKS DR
Practice Address - Street 2:
Practice Address - City:OAK RIDGE
Practice Address - State:NC
Practice Address - Zip Code:27310-9844
Practice Address - Country:US
Practice Address - Phone:336-392-2170
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5321101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor