Individual provider Active NPI

Meghan Lyn Mallams, LCSW, RPT

  • Clinical Social Worker
  • Liberty, MO
National Provider Identifier
1336748599
Registry record updated Nov 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
2012002398 Issued in MO
Practice address
28 Westwoods Dr Ste 107
Liberty, MO 64068-3520
Phone
(816) 368-1322
NPI assigned
Oct 20, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 2012002398 MO Primary

Addresses

Primary practice location

28 Westwoods Dr Ste 107
Liberty, MO 64068-3520

Mailing address

28 Westwoods Dr Ste 107
Liberty, MO 64068-3520
Phone (816) 368-1322

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
2012002398MOMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1603152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605571200000",
    "number": "1336748599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28 WESTWOODS DR STE 107",
            "city": "LIBERTY",
            "state": "MO",
            "postal_code": "640683520",
            "telephone_number": "816-368-1322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28 WESTWOODS DR STE 107",
            "city": "LIBERTY",
            "state": "MO",
            "postal_code": "640683520",
            "telephone_number": "816-368-1322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALLAMS",
        "first_name": "MEGHAN",
        "middle_name": "LYN",
        "credential": "LCSW, RPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-20",
        "last_updated": "2020-11-17",
        "certification_date": "2020-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2012002398",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Liberty, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 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.

Verify at the official NPI Registry.