Individual provider Active NPI

Kathy L. Mallow, M.S.W.

  • Clinical Social Worker
  • Hoboken, NJ
National Provider Identifier
1366566978
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
44SC00870800 Issued in NJ
Practice address
132 Washington St
Suite 203
Hoboken, NJ 07030-4646
Phone
(201) 222-1869
NPI assigned
Mar 19, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 44SC00870800 NJ Primary
Clinical Social Worker 1041C0700X 045046 NY

Addresses

Primary practice location

132 Washington St
Suite 203
Hoboken, NJ 07030-4646

Mailing address

526 Bloomfield St
#2
Hoboken, NJ 07030-4911
Phone (201) 222-1869

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
44SC00870800NJMDClinical Social Worker
045046NYMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1366566978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "526 BLOOMFIELD ST",
            "address_2": "#2",
            "city": "HOBOKEN",
            "state": "NJ",
            "postal_code": "070304911",
            "telephone_number": "201-222-1869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "132 WASHINGTON ST",
            "address_2": "SUITE 203",
            "city": "HOBOKEN",
            "state": "NJ",
            "postal_code": "070304646",
            "telephone_number": "201-222-1869"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALLOW",
        "first_name": "KATHY",
        "middle_name": "L.",
        "name_prefix": "Ms.",
        "credential": "M.S.W.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC00870800",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "045046",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hoboken, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.