Scott Robert Mallon

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

000874-1 Issued in NY

Practice address

1688 Victory Blvd
Staten Island, NY 10314-3547

Phone

(718) 815-4111

NPI assigned

Jul 25, 2011

Sex

Male

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

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jul 1, 2026 through Jul 1, 2028

Specialty

Marriage and Family Therapist

Education

Other, 2009

Medicare assignment

May accept Medicare assignment

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.

• Senior Care Therapy LLC

  • Clinical Psychologist
  • Passaic, NJ
  • NPI 1285898098

  Marriage & Family Therapist

  NPD

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

{
    "created_epoch": "1311552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1311552000000",
    "number": "1700164803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1688 VICTORY BLVD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103143547",
            "telephone_number": "718-815-4111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1688 VICTORY BLVD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103143547",
            "telephone_number": "718-815-4111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALLON",
        "first_name": "SCOTT",
        "middle_name": "ROBERT",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-25",
        "last_updated": "2011-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NY",
            "license": "000874-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brianna Frances Mallia, M.S., CCC-SLP
• Daniela Rose Mallia, M.S. OTR/L
• Ali Imran Mallick
• Sanford Mallin, MD
• Emily Sharon Mallinger, MD
• Ellen Malloy
• Amanda G Malone
• Kathleen Ann Malone, ANP, RN
• Erin Maloney
• Shakila Veronica Maloratsky, RN

• Marriage & Family Therapist in Staten Island, NY
• Providers in Staten Island, NY by specialty
• Marriage & Family Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• 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.