Larry Mallory, LCDCII

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

976259 Issued in OH

Practice address

1515 E Broad St
Columbus, OH 43205-1550

Phone

(614) 251-0711

NPI assigned

May 3, 2017

Sex

Male

Sole proprietor

Yes

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 and National Provider Directory roles.

• Verity Behavioral Services

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Columbus, OH
  • NPI 1124722335

  Addiction (Substance Use Disorder)

  NPD (past)
• Verity Behavioral Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Columbus, OH
  • NPI 1225865082
  NPD (past)

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

{
    "created_epoch": "1493769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493769600000",
    "number": "1134655640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9902 HOOVER WOODS RD",
            "city": "GALENA",
            "state": "OH",
            "postal_code": "430219482",
            "telephone_number": "740-815-4739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 E BROAD ST",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432051550",
            "telephone_number": "614-251-0711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALLORY",
        "first_name": "LARRY",
        "credential": "LCDCII",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-05-03",
        "last_updated": "2017-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "976259",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tricia Lynne Malley, CNP
• Hema Mallick, DDS
• Monisha K Mallik, DC
• Angela Monique Mallory, CDCA
• April Larayne Mallory, RN
• Noah Thomas Mallory, MD
• Catherine Malloy
• Colleen Marie Malloy, PA-C
• Deborah A Malloy, CNP
• Kelsie N Malloy, APRN-CNP, PNP-AC

• Addiction (Substance Use Disorder) Counselor in Columbus, OH
• Providers in Columbus, OH by specialty
• Addiction (Substance Use Disorder) Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 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.