Active NPI
Mallory Mattie, LMSW
- Social Worker
- Cumming, GA
National Provider Identifier
1326640426
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- MSW009614
- Practice address
- 1435 Haw Creek Cir
Cumming, GA 30041-6566 - Phone
- (470) 253-1963
- NPI assigned
- Nov 12, 2020
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Social Worker | 104100000X | MSW009614 | GA | Primary |
Addresses
Primary practice location
1435 Haw Creek Cir
Cumming, GA 30041-6566
Mailing address
56 Choctaw RDG S
Dahlonega, GA 30533-5627
Phone (678) 231-3901
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 |
|---|---|---|---|
| MSW009614 | GA | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1605139200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1605139200000",
"number": "1326640426",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "56 CHOCTAW RDG S",
"city": "DAHLONEGA",
"state": "GA",
"postal_code": "305335627",
"telephone_number": "678-231-3901"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1435 HAW CREEK CIR",
"city": "CUMMING",
"state": "GA",
"postal_code": "300416566",
"telephone_number": "470-253-1963"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATTIE",
"first_name": "MALLORY",
"credential": "LMSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-11-12",
"last_updated": "2020-11-12",
"certification_date": "2020-11-12",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "GA",
"license": "MSW009614",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cumming, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 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.