Individual provider Active NPI

Mallory Carr

  • Mental Health Counselor
  • Indianapolis, IN
National Provider Identifier
1306253638
Registry record updated Dec 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
39002571A Issued in IN
Practice address
9135 N Meridian St Ste A4
Indianapolis, IN 46260-1815
Phone
(317) 937-0149
NPI assigned
Jul 18, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 39002571A IN Primary

Addresses

Primary practice location

9135 N Meridian St Ste A4
Indianapolis, IN 46260-1815

Mailing address

9135 N Meridian St Ste A4
Indianapolis, IN 46260-1815
Phone (317) 937-0149

Other practice location 1

8320 Madison Ave
Indianapolis, IN 46227-6066
Phone (317) 882-5122

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

LicenseStateTypeSpecialty
39002571AINMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1405641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543795200000",
    "number": "1306253638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9135 N MERIDIAN ST STE A4",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462601815",
            "telephone_number": "317-937-0149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9135 N MERIDIAN ST STE A4",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462601815",
            "telephone_number": "317-937-0149"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8320 Madison Ave",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462276066",
            "country_code": "US",
            "telephone_number": "317-882-5122",
            "fax_number": "317-888-8642",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARR",
        "first_name": "MALLORY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-18",
        "last_updated": "2018-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IN",
            "license": "39002571A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2018; 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.