Mallory Enola O'Brien

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LH61589928 Issued in WA

Practice address

1500 Roma Rd
Bellingham, WA 98226-7801

Phone

(206) 669-4604

NPI assigned

Sep 26, 2020

Last updated

Oct 24, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Mindful Therapy Group PC

  dba Mindful Therapy Group

  • Clinical Social Worker
  • Mountlake Terrace, WA
  • NPI 1316238678

  Mental Health

  Medicare reassignment NPD

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

{
    "created_epoch": "1601078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729728000000",
    "number": "1487261186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4908 SW MORGAN ST",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981361356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 ROMA RD",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982267801",
            "telephone_number": "206-669-4604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'BRIEN",
        "first_name": "MALLORY",
        "middle_name": "ENOLA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-26",
        "last_updated": "2024-10-24",
        "certification_date": "2024-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LH61589928",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• NW Therapy Solutions PLLC
• Elizabeth Nyblade, PH.D.
• Kristine Elin Nystrom, LPC
• Elissa Noel O Grady, LMP
• Kimberly S O'Brien, LMHC
• Michelle O'Brien, RN
• Sharon L O'Connell
• Theresa O'Connor
• Christopher Ian O'Dell, LMP
• Laurinda Joann O'Halloran, L.M.P.

• Mental Health Counselor in Bellingham, WA
• Providers in Bellingham, WA by specialty
• Mental Health Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.