Mya Marie Mallad, LLMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801112369 Issued in MI

Practice address

8001 Angling Rd
Portage, MI 49024-7422

Phone

(269) 321-7090

NPI assigned

Mar 29, 2022

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1648512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648512000000",
    "number": "1548900780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50634 SILVERTON",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481877703",
            "telephone_number": "313-247-8270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8001 ANGLING RD",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490247422",
            "telephone_number": "269-321-7090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALLAD",
        "first_name": "MYA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "LLMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-29",
        "last_updated": "2022-03-29",
        "certification_date": "2022-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801112369",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "laptop",
            "affiliation": "N",
            "endpointDescription": "individually assigned technology equipment",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "8001 Angling Rd",
            "city": "Portage",
            "state": "MI",
            "country_code": "US",
            "postal_code": "490247422",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Ellie Jane Makoul, PA-C
• David Makowski
• Lisa Marie Makuch, PHD
• Ryan Malarney, DC
• Sarah Malarney, D.C.
• Raymond Joseph Maly, DDS
• Brandon J Manderle, MD
• Manjerngie Ndebe Ngovo MPS Global
• Brandy Mae Manning
• Stacy Annmarie Manski, PA-C

• Clinical Social Worker in Portage, MI
• Providers in Portage, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 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.

Verify at the official NPI Registry.