Active NPI
Laura Ellen Malley, LPC
- Professional Counselor
- Wood River, IL
National Provider Identifier
1073654059
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 002657
- Practice address
- 549 N 1St St
Wood River, IL 62095-1504 - Phone
- (618) 254-2911
- NPI assigned
- Feb 10, 2007
- Last updated
- Jul 8, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 002657 | MO | Primary |
Addresses
Primary practice location
549 N 1St St
Wood River, IL 62095-1504
Mailing address
549 N 1St St
Wood River, IL 62095-1504
Phone (618) 254-2911
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 002657 | MO | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171065600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1073654059",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "549 N 1ST ST",
"city": "WOOD RIVER",
"state": "IL",
"postal_code": "620951504",
"telephone_number": "618-254-2911"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "549 N 1ST ST",
"city": "WOOD RIVER",
"state": "IL",
"postal_code": "620951504",
"telephone_number": "618-254-2911"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MALLEY",
"first_name": "LAURA",
"middle_name": "ELLEN",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-02-10",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MO",
"license": "002657",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wood River, IL
- Johnson's Auditory Sales & Service, Inc. (Johnson's Hearing Center)
- Johnson's Auditory Sales & Service, Inc. (Johnson's Hearing Center)
- Brandon Christopher Kopp, PHARMD
- Angelina M Leitschuh, NP
- Jennifer Melynne McAfee Maag, PH.D., LCPC, LPC
- Dillon Gene Manion, PT, DPT
- Donald Edward Mayden
- Jami L. Mayhew, N.P.
- Melissa McHenry, LCPC
- Amanda C McMurray, CADC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.