Amy Tyler Mallory-Smith, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Practice address

9040 Jackson Ave Madigan Army Medical Center
Tacoma, WA 98431-0001

Phone

(206) 851-7427

NPI assigned

Jan 24, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Feb 17, 2023 through Feb 17, 2027

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1232755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550707200000",
    "number": "1235377581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9040 JACKSON AVE",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984310001",
            "telephone_number": "206-851-7427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9040 JACKSON AVE MADIGAN ARMY MEDICAL CENTER",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984310001",
            "telephone_number": "206-851-7427"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2650 NE Courtney",
            "address_2": "Dept of Veterans Affairs Bend CBOC",
            "address_purpose": "LOCATION",
            "city": "Bend",
            "state": "OR",
            "postal_code": "97701",
            "country_code": "US",
            "telephone_number": "206-851-7427",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MALLORY-SMITH",
        "first_name": "AMY",
        "middle_name": "TYLER",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-01-24",
        "last_updated": "2019-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vinay Malhotra, MD
• Rabia Khalid Malik, DO
• Jessica Malley, PHD
• Sean Aaron Mallon, D.O
• Timothy D Mallon, LMHC
• Bradford Heath Mallory, M.D.
• Leslie S Malo, MD
• Duncan Riley Malone
• Emma Antoinette Malone, PHARMD
• Mallory Malone

• Clinical Social Worker in Tacoma, WA
• Providers in Tacoma, WA by specialty
• Clinical Social Worker in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.