Organization Active NPI

Mallard Mental Wellness LLC

  • Professional Counselor
  • Darlington, SC
National Provider Identifier
1124770938
Registry record updated Nov 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Legal business name
MALLARD MENTAL WELLNESS LLC
Practice address
105 Russell St
Darlington, SC 29532-3309
Phone
(843) 624-8661
NPI assigned
Jan 23, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2025

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

Authorized official

Name
Laura L Smith, LPC, LPCSNPI 1124353404
Title
Owner/Operator
Phone
(843) 624-8661

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YP2500X Primary

Addresses

Primary practice location

105 Russell St
Darlington, SC 29532-3309

Mailing address

116 Oakview Dr
Darlington, SC 29532-2510
Phone (843) 624-8661

Other identifiers 1

IdentifierTypeStateIssuer
PC1001MedicaidSC

National Provider Directory

National Provider Directory

Locations

105 Russell St
Darlington, SC 29532
Phone (843) 624-8661

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1642896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1764115200000",
    "number": "1124770938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 OAKVIEW DR",
            "city": "DARLINGTON",
            "state": "SC",
            "postal_code": "295322510",
            "telephone_number": "843-624-8661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 RUSSELL ST",
            "city": "DARLINGTON",
            "state": "SC",
            "postal_code": "295323309",
            "telephone_number": "843-624-8661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MALLARD MENTAL WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-23",
        "last_updated": "2025-11-26",
        "certification_date": "2025-11-26",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "LAURA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER/OPERATOR",
        "authorized_official_telephone_number": "843-624-8661",
        "authorized_official_credential": "LPC, LPCS"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PC1001",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Darlington, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2025; 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.