Active NPI
Mallorie E Davis, LSW
- Clinical Social Worker
- Columbus, OH
National Provider Identifier
1205445145
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- S.2004685
- Practice address
- 1350 W 5TH Ave Ste 112
Columbus, OH 43212-2907 - Phone
- (614) 233-1062
- NPI assigned
- Jul 27, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | S.2004685 | OH | Primary |
Addresses
Primary practice location
1350 W 5TH Ave Ste 112
Columbus, OH 43212-2907
Mailing address
1350 W 5TH Ave Ste 112
Columbus, OH 43212-2907
Phone (614) 233-1062
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
| License | State | Type | Specialty |
|---|---|---|---|
| S.2004685 | OH | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Chante Meadows, LLC | Past | 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.
-
- Community/Behavioral Health Agency
- Columbus, OH
- NPI 1194140921
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1595808000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1595808000000",
"number": "1205445145",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1350 W 5TH AVE STE 112",
"city": "COLUMBUS",
"state": "OH",
"postal_code": "432122907",
"telephone_number": "614-233-1062"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1350 W 5TH AVE STE 112",
"city": "COLUMBUS",
"state": "OH",
"postal_code": "432122907",
"telephone_number": "614-233-1062"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "MALLORIE",
"middle_name": "E",
"credential": "LSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-07-27",
"last_updated": "2020-07-27",
"certification_date": "2020-07-27",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Social Worker, Clinical",
"state": "OH",
"license": "S.2004685",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Columbus, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.