Michael Floyd Mallory, MSW, LCSW

Primary specialty

Social WorkerTaxonomy code 104100000X

Practice address

4100 Veterans Pkwy
McHenry, IL 60050-8350

Phone

(815) 759-7032

Fax

(815) 759-7298

NPI assigned

Apr 29, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Midwest Healing & Clarity

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Chicago, IL
  • NPI 1891443594
  NPD Authorized official

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

{
    "created_epoch": "1367193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647043200000",
    "number": "1164866554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4655 N SPAULDING AVE APT 2",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606256923",
            "telephone_number": "630-386-1613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 VETERANS PKWY",
            "city": "MCHENRY",
            "state": "IL",
            "postal_code": "600508350",
            "telephone_number": "815-759-7032",
            "fax_number": "815-759-7298"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1801 W Warner Ave Ste 200",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606131891",
            "country_code": "US",
            "telephone_number": "630-386-1613",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MALLORY",
        "first_name": "MICHAEL",
        "middle_name": "FLOYD",
        "name_prefix": "Mr.",
        "credential": "MSW, LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-29",
        "last_updated": "2022-03-12",
        "certification_date": "2022-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "362480845",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Majestic Massage & Stretching LLC
• Delaram Majlesi, M.D.
• Karina Maksimova
• Jennifer Malenius
• Komal Malik, MD
• Daniel Malone
• Paula Jean Mantas, LPN
• Caroline Manyika Willoughby
• Jennifer Marano
• Laura Maras

• Social Worker in McHenry, IL
• Providers in McHenry, IL by specialty
• Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2022; 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.