1407458706 NPI number — AMANDA KATHLEEN NOBLES MALSON LCMHC, LPC

Table of content: AMANDA KATHLEEN NOBLES MALSON LCMHC, LPC (NPI 1407458706)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1407458706 NPI number — AMANDA KATHLEEN NOBLES MALSON LCMHC, LPC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MALSON
Provider First Name:
AMANDA
Provider Middle Name:
KATHLEEN NOBLES
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LCMHC, LPC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
NOBLES
Provider Other First Name:
AMANDA
Provider Other Middle Name:
KATHLEEN
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1407458706
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/15/2026
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 87016
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FAYETTEVILLE
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28304-7016
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
910-850-6271
Provider Business Mailing Address Fax Number:
980-495-8868

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
PO BOX 87016
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FAYETTEVILLE
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28304-7016
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
910-850-6271
Provider Business Practice Location Address Fax Number:
980-495-8868
Provider Enumeration Date:
11/11/2020

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YP2500X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 101YM0800X , with the licence number: 15886 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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