Mallory Diana Charland, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

089.0135917 Issued in VT

Practice address

42 Susie Wilson Rd Unit 111
Essex Junction, VT 05452-2856

Phone

(802) 404-2185

NPI assigned

Jun 19, 2024

Sex

Female

Sole proprietor

Yes

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 VT

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

Specialty

Clinical Social Worker

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

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 and National Provider Directory roles.

• Calm Waters, LLC

  • Clinical Social Worker
  • Essex Junction, VT
  • NPI 1124977319

  Clinical, VT

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1718755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755129600000",
    "number": "1497599047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42 SUSIE WILSON RD UNIT 111",
            "city": "ESSEX JUNCTION",
            "state": "VT",
            "postal_code": "054522856",
            "telephone_number": "028-922-7672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42 SUSIE WILSON RD UNIT 111",
            "city": "ESSEX JUNCTION",
            "state": "VT",
            "postal_code": "054522856",
            "telephone_number": "802-404-2185"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "462 Hegeman Ave Ste 200",
            "address_purpose": "LOCATION",
            "city": "Colchester",
            "state": "VT",
            "postal_code": "054463187",
            "country_code": "US",
            "telephone_number": "802-661-4376",
            "fax_number": "802-655-1130",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHARLAND",
        "first_name": "MALLORY",
        "middle_name": "DIANA",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-06-19",
        "last_updated": "2025-08-14",
        "certification_date": "2025-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VT",
            "license": "089.0135917",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cave Counseling, PLLC
• Champlain Language Connection PLC
• Champlain Obstetrics and Gynecology, P.C.
• Champlain Sports Medicine PC
• Champlain Valley Foot & Ankle, P.C.
• Leah Chiarmonte
• Chittenden County Chiropractic Inc.
• Chittenden Home Care Agency LLC
• Heather Lee Church
• Kayla Michele Ciampa Zwicky, DNP, APRN, AGNP-C

• All providers in Essex Junction, VT
• Clinical Social Worker in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2025; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.