Nathaniel Mallard

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CW027546 Issued in PA

Practice address

4601 Market St
Philadelphia, PA 19139-4636

Phone

(215) 220-2127

NPI assigned

Aug 21, 2025

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1755734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785715200000",
    "number": "1164309969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4601 MARKET ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191394636",
            "telephone_number": "215-220-2127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4601 MARKET ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191394636",
            "telephone_number": "215-220-2127"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2801 Grant Ave",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191141032",
            "country_code": "US",
            "telephone_number": "215-878-3400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MALLARD",
        "first_name": "NATHANIEL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-08-21",
        "last_updated": "2026-08-03",
        "certification_date": "2026-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW027546",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "PA",
            "license": "SW142961",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anna Malkov
• Stanley Malkowicz, MD
• Cristal Mallah, MA
• Radmila Mallah, CRNP
• Clare Mallahan
• Kashka Mallari, MD
• Louise Malle, MD, PHD
• Tejaswee Mallela, MD
• Eric S Maller, M.D.
• Stephanie Christine Mallgrave, CRNP

• Clinical Social Worker in Philadelphia, PA
• Providers in Philadelphia, 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 3, 2026; 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.