Individual provider Active NPI

Mallory Stevens

  • Clinical Social Worker
  • Cuyahoga Falls, OH
National Provider Identifier
1407346018
Registry record updated Jul 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I.2405092 Issued in OH
Practice address
421 Graham Rd Ste B
Cuyahoga Falls, OH 44221-1344
Phone
(330) 510-4900
NPI assigned
May 18, 2018
Last updated
Jul 10, 2024By the provider in NPPES
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2024

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 I.2405092 OH Primary

Addresses

Primary practice location

421 Graham Rd Ste B
Cuyahoga Falls, OH 44221-1344

Mailing address

421 Graham Rd Ste B
Cuyahoga Falls, OH 44221-1344
Phone (703) 786-3009

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
I.2405092OHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Azalea Institute-Center for MFT & LPC Advancement, LLC Clinical CurrentSince Dec 8, 2024 Accepting new patients

Locations

421 Graham Rd
Ste B
Cuyahoga Fls, OH 44221
Phone (330) 510-4900

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1526601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720569600000",
    "number": "1407346018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "421 GRAHAM RD STE B",
            "city": "CUYAHOGA FALLS",
            "state": "OH",
            "postal_code": "442211344",
            "telephone_number": "703-786-3009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "421 GRAHAM RD STE B",
            "city": "CUYAHOGA FALLS",
            "state": "OH",
            "postal_code": "442211344",
            "telephone_number": "330-510-4900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEVENS",
        "first_name": "MALLORY",
        "sole_proprietor": "NO",
        "sex": "U",
        "enumeration_date": "2018-05-18",
        "last_updated": "2024-07-10",
        "certification_date": "2024-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.2405092",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cuyahoga Falls, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2024; 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.