Individual provider Active NPI

Mariesarah Kristelle Malval

  • Psychologist
  • Miami, FL
National Provider Identifier
1164032488
Registry record updated Oct 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
SS1493 Issued in FL
Practice address
11831 SW 102ND St
Miami, FL 33186-2748
Phone
(786) 205-3703
NPI assigned
Aug 1, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 29, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X SS1493 FL Primary
School PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TS0200X SS1493 FL

Addresses

Primary practice location

11831 SW 102ND St
Miami, FL 33186-2748

Mailing address

11831 SW 102ND St
Miami, FL 33186-2748
Phone (786) 205-3703

Other practice location 1

4812 SW 74th Ct # 3
Miami, FL 33155-4448
Phone (786) 529-8378

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
SS1493FLMDSchool Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Academic, Behavioral, and Cognitive Testing Services LLC Psychologist PastSince Oct 5, 2025 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1596240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761696000000",
    "number": "1164032488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11831 SW 102ND ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331862748",
            "telephone_number": "786-205-3703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11831 SW 102ND ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331862748",
            "telephone_number": "786-205-3703"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4812 SW 74th Ct # 3",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331554448",
            "country_code": "US",
            "telephone_number": "786-529-8378",
            "fax_number": "786-400-2134",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MALVAL",
        "first_name": "MARIESARAH KRISTELLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-08-01",
        "last_updated": "2025-10-29",
        "certification_date": "2025-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "FL",
            "license": "SS1493",
            "primary": true
        },
        {
            "code": "103TS0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, School",
            "state": "FL",
            "license": "SS1493",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 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.