Mallori Lynne Cusumano, LLMSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

6851105390 Issued in MI

Practice address

70182 Place Rd
Richmond, MI 48062-5031

Phone

(231) 838-7746

NPI assigned

Apr 27, 2022

Last updated

Mar 24, 2023By 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.

• Richard Kneip, PH.D., P.C.

  dba Great Lakes Psychology Group

  • Community/Behavioral Health Agency
  • Clarkston, MI
  • NPI 1679739700
  NPD (past)

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

{
    "created_epoch": "1651017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679616000000",
    "number": "1093459703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "70182 PLACE RD",
            "city": "RICHMOND",
            "state": "MI",
            "postal_code": "480625031",
            "telephone_number": "231-838-7746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70182 PLACE RD",
            "city": "RICHMOND",
            "state": "MI",
            "postal_code": "480625031",
            "telephone_number": "231-838-7746"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13001 23 Mile Rd Ste 103",
            "address_purpose": "LOCATION",
            "city": "Shelby Township",
            "state": "MI",
            "postal_code": "483152767",
            "country_code": "US",
            "telephone_number": "248-453-7525",
            "fax_number": "248-605-3525",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CUSUMANO",
        "first_name": "MALLORI",
        "middle_name": "LYNNE",
        "name_prefix": "Mrs.",
        "credential": "LLMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-27",
        "last_updated": "2023-03-24",
        "certification_date": "2023-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6851105390",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stacy L Conn, NP
• Dawn Cordone
• Corporate Health Solutions, Inc
• Melissa Cripps
• Elena Maria Cuellar
• Darlene Ann Daniels I, PT
• Billie Lettice Davis
• Dawn Piascik L.L.C. (The Education Station for Health Care)
• Jennifer Lynn Deel
• Misty Jean Deleon, MA, TLLP, DP-C

• Social Worker in Richmond, MI
• Providers in Richmond, MI by specialty
• Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2023; 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.