Active NPI
Paul Douglas Mallamo, LAC
- Addiction (Substance Use Disorder) Counselor
- Olathe, KS
National Provider Identifier
1346832250
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 1677
- Practice address
- 1009 E Old Highway 56
Olathe, KS 66061-4969 - Phone
- (913) 764-7555
- Fax
- (913) 764-0739
- NPI assigned
- Feb 11, 2021
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 1677 | KS | Primary |
Addresses
Primary practice location
1009 E Old Highway 56
Olathe, KS 66061-4969
Mailing address
1601 Old South River Rd
Saint Charles, MO 63303-4120
Phone (636) 224-1210
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 |
|---|---|---|---|
| 1677 | KS | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1613001600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1613001600000",
"number": "1346832250",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1601 OLD SOUTH RIVER RD",
"city": "SAINT CHARLES",
"state": "MO",
"postal_code": "633034120",
"telephone_number": "636-224-1210",
"fax_number": "636-246-1008"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1009 E OLD HIGHWAY 56",
"city": "OLATHE",
"state": "KS",
"postal_code": "660614969",
"telephone_number": "913-764-7555",
"fax_number": "913-764-0739"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MALLAMO",
"first_name": "PAUL",
"middle_name": "DOUGLAS",
"credential": "LAC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-02-11",
"last_updated": "2021-02-11",
"certification_date": "2021-02-11",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "KS",
"license": "1677",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Olathe, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.