Active NPI
Mallory Ann McDonough, LMSW
- Clinical Social Worker
- Warren, MI
National Provider Identifier
1144569559
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 6801093434
- Practice address
- 11800 E 12 Mile Rd
Warren, MI 48093-3472 - Phone
- (586) 573-5872
- NPI assigned
- Feb 5, 2013
- 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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 6801093434 | MI | Primary |
Addresses
Primary practice location
11800 E 12 Mile Rd
Warren, MI 48093-3472
Mailing address
11800 E 12 Mile Rd
Warren, MI 48093-3472
Phone (586) 573-5872
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1360022400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1556236800000",
"number": "1144569559",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11800 E 12 MILE RD",
"city": "WARREN",
"state": "MI",
"postal_code": "480933472",
"telephone_number": "586-573-5872"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11800 E 12 MILE RD",
"city": "WARREN",
"state": "MI",
"postal_code": "480933472",
"telephone_number": "586-573-5872"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCDONOUGH",
"first_name": "MALLORY",
"middle_name": "ANN",
"credential": "LMSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-02-05",
"last_updated": "2019-04-26",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MI",
"license": "6801093434",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Warren, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.