Nicole Mallory, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CW027715 Issued in PA

Practice address

4309 Linglestown Rd
Harrisburg, PA 17112-8624

Phone

(717) 412-4908

NPI assigned

Nov 27, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1574812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786924800000",
    "number": "1164069902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4309 LINGLESTOWN RD",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171128624",
            "telephone_number": "717-557-8277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4309 LINGLESTOWN RD",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171128624",
            "telephone_number": "717-412-4908"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 Mulberry St Ste 201",
            "address_purpose": "LOCATION",
            "city": "Scranton",
            "state": "PA",
            "postal_code": "185031233",
            "country_code": "US",
            "telephone_number": "570-955-5479",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MALLORY",
        "first_name": "NICOLE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-11-27",
        "last_updated": "2026-08-17",
        "certification_date": "2026-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW027715",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Nicole@integrativecounselingpc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "4309 Linglestown Rd",
            "city": "Harrisburg",
            "state": "PA",
            "country_code": "US",
            "postal_code": "171128624",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Sharon Malatestinic, RN
• Ravindra Khimjibhai Malavia, RPH
• Holly Ann Maley, CRNA
• Khurram Malik, NP
• Nancy M Mallis, OTR/L
• Ulkar Mammadli, MD
• Alireza Manafi
• Cameron Lyn Manahan, LCSW
• Julie Mandel
• Michael Jay Mandell, MD

• Clinical Social Worker in Harrisburg, PA
• Providers in Harrisburg, PA by specialty
• Clinical Social Worker in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2026; 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.