Mallory Kiernan, APSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

130860 Issued in WI

Practice address

778 Lois Dr
Sun Prairie, WI 53590-1100

Phone

(608) 755-5260

Fax

(608) 755-5267

NPI assigned

Nov 20, 2017

Last updated

Nov 20, 2017By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

• Trivium LLC

  dba Crossroads Counseling Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Janesville, WI
  • NPI 1265450753
  NPD (past)
• Trivium LLC

  dba Crossroads Counseling Center

  • Adolescent and Children Mental Health Clinic/Center
  • Sun Prairie, WI
  • NPI 1427463066
  NPD (past)

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

{
    "created_epoch": "1511136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1511136000000",
    "number": "1073027538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 S RIVER ST STE 254",
            "city": "JANESVILLE",
            "state": "WI",
            "postal_code": "535483863",
            "telephone_number": "608-755-5260",
            "fax_number": "608-755-5267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "778 LOIS DR",
            "city": "SUN PRAIRIE",
            "state": "WI",
            "postal_code": "535901100",
            "telephone_number": "608-755-5260",
            "fax_number": "608-755-5267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIERNAN",
        "first_name": "MALLORY",
        "credential": "APSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-20",
        "last_updated": "2017-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "WI",
            "license": "130860",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda E Kafka, APNP
• Kaleidoscope Collaborative Care
• Margaret Karpinen, MSOT
• James Kasenow, H.I.S.
• David G Kass, DO
• Kim Whitmore Private Duty
• Roy B Kim, M.D.
• Kimberly Berndt, Pmhnp-BC LLC
• Nina M Kinnunen, MD
• Sara M Kirkman, DC

• Social Worker in Sun Prairie, WI
• Providers in Sun Prairie, WI by specialty
• Social Worker in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.