Mallory Misljenovic, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

64097 Issued in TX

Practice address

4215 Joe Ramsey Blvd E
Greenville, TX 75401-7852

Phone

(903) 408-5000

NPI assigned

Jun 17, 2021

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

Other names 1

• Mallory Quinn Former name

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Hunt Memorial Hospital District

  • General Acute Care Hospital
  • Greenville, TX
  • NPI 1598750721
  Medicare reassignment NPD
• Hunt Memorial Hospital District

  • Skilled Nursing Facility
  • Royse City, TX
  • NPI 1750833901
  NPD

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

{
    "created_epoch": "1623888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623888000000",
    "number": "1154990802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "512 AIRPORT RD",
            "city": "SULPHUR SPRINGS",
            "state": "TX",
            "postal_code": "754822008",
            "telephone_number": "903-440-4611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4215 JOE RAMSEY BLVD E",
            "city": "GREENVILLE",
            "state": "TX",
            "postal_code": "754017852",
            "telephone_number": "903-408-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MISLJENOVIC",
        "first_name": "MALLORY",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-17",
        "last_updated": "2021-06-17",
        "certification_date": "2021-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "64097",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MALLORY",
            "last_name": "QUINN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jayna Middleton, FNP
• Kimberly Elaine Middleton, NP
• Ruth Jordan Miller
• Shelby Miller, MD
• Lauren Marie Mims, D.C.
• Stacy Ann Mitchell Doyle, M.D.
• Amelia K Mitchell, SLP
• Billy Don Mitchell, M.D.
• Elizabeth Ann Moberg
• Mobile Physician Services, PLLC

• Clinical Social Worker in Greenville, TX
• Providers in Greenville, TX by specialty
• Clinical Social Worker in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2021; 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.

Verify at the official NPI Registry.