Imani Sade Mallard, RN, IBCLC

Primary specialty

Lactation Consultant (Registered Nurse)Taxonomy code 163WL0100X

License

L-319151 Issued in MD

Practice address

1020 19TH St NW Ste 150
Washington, DC 20036-6103

Phone

(202) 293-5182

NPI assigned

Aug 18, 2025

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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.

• New BCGW Corp

  • Lactation Consultant (Registered Nurse)
  • Washington, DC
  • NPI 1427534783
  NPD (past)

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

{
    "created_epoch": "1755475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755475200000",
    "number": "1285511683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10945 PRICE MANOR WAY",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207236036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 19TH ST NW STE 150",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200366103",
            "telephone_number": "202-293-5182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALLARD",
        "first_name": "IMANI",
        "middle_name": "SADE",
        "credential": "RN, IBCLC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-08-18",
        "last_updated": "2025-08-18",
        "certification_date": "2025-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WN0002X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Neonatal Intensive Care",
            "state": "MD",
            "license": "R254502",
            "primary": false
        },
        {
            "code": "163WN0003X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Neonatal, Low-Risk",
            "state": "DC",
            "license": "RN500016940",
            "primary": false
        },
        {
            "code": "163WL0100X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Lactation Consultant",
            "state": "MD",
            "license": "L-319151",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sali Rahamatu Mallam
• Alisha Mallard
• Brianna Le'Shea Mallard
• Carolynn Mallard
• Demetrius Mallard
• Nada Mallick, MD
• Roudolphe Lepere Mallong Kombi
• Asia Mallory
• Bianca Mallory
• Katherine Olivia Mallory, M.D.

• Lactation Consultant (Registered Nurse) in Washington, DC
• Providers in Washington, DC by specialty
• Lactation Consultant (Registered Nurse) in District of Columbia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2025; 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.