Active NPI
Mallory Williams, LMSW LSSW
- Social Worker
- Olive Branch, MS
National Provider Identifier
1750732855
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 10537
- Practice address
- 7229 Stone Garden Dr
Olive Branch, MS 38654-6419 - Phone
- (870) 692-8102
- NPI assigned
- Jun 29, 2016
- Last updated
- Jun 29, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 10537 | TN | Primary |
| School Social Worker | 1041S0200X | 000634883 | TN |
Addresses
Primary practice location
7229 Stone Garden Dr
Olive Branch, MS 38654-6419
Mailing address
7229 Stone Garden Dr
Olive Branch, MS 38654-6419
Phone (870) 692-8102
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10537 | TN | MD | Social Worker |
| 000634883 | TN | MD | School Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1467158400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1467158400000",
"number": "1750732855",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7229 STONE GARDEN DR",
"city": "OLIVE BRANCH",
"state": "MS",
"postal_code": "386546419",
"telephone_number": "870-692-8102"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7229 STONE GARDEN DR",
"city": "OLIVE BRANCH",
"state": "MS",
"postal_code": "386546419",
"telephone_number": "870-692-8102"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIAMS",
"first_name": "MALLORY",
"credential": "LMSW LSSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-06-29",
"last_updated": "2016-06-29",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "TN",
"license": "10537",
"primary": true
},
{
"code": "1041S0200X",
"taxonomy_group": "",
"desc": "Social Worker, School",
"state": "TN",
"license": "000634883",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Olive Branch, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.