Active NPI
Mallory Michael
- Clinical Social Worker
- Reno, NV
National Provider Identifier
1376275651
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 10086-C
- Practice address
- 975 Kirman Ave
Ch124
Reno, NV 89502 - Phone
- (775) 419-4899
- NPI assigned
- Jun 27, 2022
- Last updated
- Jun 27, 2022
- 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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 10086-C | NV | Primary |
Addresses
Primary practice location
975 Kirman Ave
Ch124
Reno, NV 89502
Mailing address
740 Long Valley Rd
Gardnerville, NV 89460-8138
Phone (775) 741-0359
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 |
|---|---|---|---|
| 10086-C | NV | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1656288000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1656288000000",
"number": "1376275651",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "740 LONG VALLEY RD",
"city": "GARDNERVILLE",
"state": "NV",
"postal_code": "894608138",
"telephone_number": "775-741-0359"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "975 KIRMAN AVE",
"address_2": "CH124",
"city": "RENO",
"state": "NV",
"postal_code": "89502",
"telephone_number": "775-419-4899"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MICHAEL",
"first_name": "MALLORY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-06-27",
"last_updated": "2022-06-27",
"certification_date": "2020-10-22",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NV",
"license": "10086-C",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Reno, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.