Mallory Kate Haberlack

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

Practice address

3321 W Kennewick Ave Ste 150
Kennewick, WA 99336-2968

Phone

(509) 735-6446

NPI assigned

May 6, 2024

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

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

{
    "created_epoch": "1714953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714953600000",
    "number": "1134976368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10251 RIDGELINE DR APT R184",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993385164",
            "telephone_number": "509-947-1368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3321 W KENNEWICK AVE STE 150",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993362968",
            "telephone_number": "509-735-6446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HABERLACK",
        "first_name": "MALLORY",
        "middle_name": "KATE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-06",
        "last_updated": "2024-05-06",
        "certification_date": "2024-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jose Guzman
• Victoria Guzman
• Amber Mae Gyles
• H Kirby Skavdahl DDS PS
• H Matt Smith MD PS
• Johanna Haberling-Mansfield, BS, CDP
• Rayel Marie Hacker
• Mahin T Hackler, REGISTERED NURSE
• Vicki Lynn Hackney, RN
• Kay D Hadley, A.R.N.P.

• Peer Specialist in Kennewick, WA
• Providers in Kennewick, WA by specialty
• Peer Specialist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2024; 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.