Jared M Malone, LMSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

41928 Issued in ID

Practice address

2201 N Ironwood PL Ste 100
Coeur D Alene, ID 83814-2670

Phone

(208) 769-4222

Fax

(844) 803-7399

NPI assigned

Apr 19, 2022

Sex

Male

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Dirne Health Centers, Inc.

  • Federally Qualified Health Center (FQHC)
  • Coeur D Alene, ID
  • NPI 1194397240

  Clinical

  NPD (past)
• Dirne Health Centers, Inc.

  • Federally Qualified Health Center (FQHC)
  • Coeur D Alene, ID
  • NPI 1255756730

  Social Worker

  NPD (past)

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

{
    "created_epoch": "1650326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650326400000",
    "number": "1669115481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1387",
            "city": "HAYDEN",
            "state": "ID",
            "postal_code": "838351387",
            "telephone_number": "208-415-0299",
            "fax_number": "208-625-2070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2201 N IRONWOOD PL STE 100",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838142670",
            "telephone_number": "208-769-4222",
            "fax_number": "844-803-7399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALONE",
        "first_name": "JARED",
        "middle_name": "M",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-04-19",
        "last_updated": "2022-04-19",
        "certification_date": "2022-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "ID",
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "ID",
            "license": "41928",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Devona Marie Mahal, LPC
• Nicole Major
• Brooke Morgan Malloy, LCSW
• Jennifer Malloy, P.T.
• Wendi Malmgren, LMSW
• Benjamin Mandel, M.D.
• Megan Marie Maney, P.T.
• Julia B Mangan, FNP
• Roger Paul Mangum, RPH
• Kameron Manley

• Social Worker in Coeur D Alene, ID
• Providers in Coeur D Alene, ID by specialty
• Social Worker in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 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.