Jamie Lee Mallon

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801117507 Issued in MI

Practice address

14799 Dix Toledo Rd
Southgate, MI 48195-2507

Phone

(313) 278-2327

NPI assigned

Oct 30, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

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, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Downriver Mental Health Clinic PCGroup PAC ID 7911995139, 289 clinicians

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.

• Downriver Mental Health Clinic PC

  dba Lifestance Health, Inc

  • Psychologist
  • Taylor, MI
  • NPI 1295866135

  Clinical

  Medicare reassignment Care Compare group NPD
• Team Wellness Center

  • Community Health Clinic/Center
  • Detroit, MI
  • NPI 1588855100
  Medicare reassignment NPD
• Downriver Mental Health Clinic PC

  dba Advanced Counseling Services PC

  • Psychologist
  • Taylor, MI
  • NPI 1104930130

  Clinical

  NPD
• Team Mental Health Services Inc.

  dba Team Wellness Center

  • Primary Care Clinic/Center
  • Detroit, MI
  • NPI 1295324291
  NPD

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

{
    "created_epoch": "1509321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704326400000",
    "number": "1629580782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14799 DIX TOLEDO RD",
            "city": "SOUTHGATE",
            "state": "MI",
            "postal_code": "481952507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14799 DIX TOLEDO RD",
            "city": "SOUTHGATE",
            "state": "MI",
            "postal_code": "481952507",
            "telephone_number": "313-278-2327"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALLON",
        "first_name": "JAMIE",
        "middle_name": "LEE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-30",
        "last_updated": "2024-01-04",
        "certification_date": "2024-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "247200000X",
            "taxonomy_group": "",
            "desc": "Technician, Other",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801117507",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jenna Malallah
• Paul Malick, D.O.
• Jonathan Malilay
• Emily Malinowski
• Samantha Anne Mall, LLMSW
• Kathryn Shannon Maloy, M.D., MPH
• Lauren Mammina
• Charlene Manners
• Heather Mannix
• Susan Mannix

• Clinical Social Worker in Southgate, MI
• Providers in Southgate, 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 Jan 4, 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.
• 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.