Madison Grace Mallory

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

C.2507511 Issued in OH

Practice address

10999 Reed Hartman Hwy
Suite 207
Blue Ash, OH 45242

Phone

(513) 999-5506

NPI assigned

Jun 6, 2023

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Alexandria Fields LLC

  • Clinical Social Worker
  • Blue Ash, OH
  • NPI 1881350148
  NPD

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

{
    "created_epoch": "1686009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758153600000",
    "number": "1700570389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10999 REED HARTMAN HWY",
            "address_2": "SUITE 207",
            "city": "BLUE ASH",
            "state": "OH",
            "postal_code": "45242",
            "telephone_number": "513-999-5506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10999 REED HARTMAN HWY",
            "address_2": "SUITE 207",
            "city": "BLUE ASH",
            "state": "OH",
            "postal_code": "45242",
            "telephone_number": "513-999-5506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALLORY",
        "first_name": "MADISON",
        "middle_name": "GRACE",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-06",
        "last_updated": "2025-09-18",
        "certification_date": "2025-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "C.2507511",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2910854",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Macarius Educational & Career Agency
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• Make Me Over Wholistic Health and Stress Management Cent LLC
• Charia Mam, FNP
• Vishakha Manek
• Kimberly Lynn Manifold
• Christine M Marasco, NP
• Juliette Marcello, APRN-CNP, PMHNP-BC

• Mental Health Counselor in Blue Ash, OH
• Providers in Blue Ash, OH by specialty
• Mental Health Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2025; 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.