Brenda W. Mallery, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

0904001113 Issued in VA

Practice address

2940 N Lynnhaven Rd
Suite 110
Virginia Beach, VA 23452-6949

Phone

(757) 450-7587

NPI assigned

Oct 26, 2006

Last updated

Feb 25, 2014By the provider in NPPES

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)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Jan D. Hembree PHD PC

  • Psychologist
  • Virginia Beach, VA
  • NPI 1821215823
  NPD (past)

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393286400000",
    "number": "1700961695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2114 BAYBERRY ST",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234511402",
            "telephone_number": "757-450-7587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2940 N LYNNHAVEN RD",
            "address_2": "SUITE 110",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234526949",
            "telephone_number": "757-450-7587"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALLERY",
        "first_name": "BRENDA",
        "middle_name": "W.",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-26",
        "last_updated": "2014-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904001113",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1861562472",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Samantha Maley, OTR/L
• Rajul Malik, MD
• Edgardo Gabriel Malinis Jr., RRT
• Ashley Malito
• Irene Marie Mallenbaum, LCSW
• Lauren Mallette, OTR/L
• Zachary Mallette
• Kim Mallon
• Dale Larrie Mallory, D.D.S.
• Shanita Mallory, LPC

• Clinical Social Worker in Virginia Beach, VA
• Providers in Virginia Beach, VA by specialty
• Clinical Social Worker in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2014; 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.