Ellie Grace Maly, LLMSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

6851119016 Issued in MI

Practice address

1420 University Ave
Flint, MI 48504-6208

Phone

(810) 238-0475

NPI assigned

Nov 22, 2024

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1732233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732233600000",
    "number": "1780400846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1420 UNIVERSITY AVE",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485046208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1420 UNIVERSITY AVE",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485046208",
            "telephone_number": "810-238-0475"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2399 E Walton Blvd",
            "address_purpose": "LOCATION",
            "city": "Auburn Hills",
            "state": "MI",
            "postal_code": "483261955",
            "country_code": "US",
            "telephone_number": "248-475-6300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6900 E 10 Mile Rd",
            "address_purpose": "LOCATION",
            "city": "Center Line",
            "state": "MI",
            "postal_code": "480151168",
            "country_code": "US",
            "telephone_number": "586-501-3070",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MALY",
        "first_name": "ELLIE",
        "middle_name": "GRACE",
        "credential": "LLMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-11-22",
        "last_updated": "2024-11-22",
        "certification_date": "2024-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6851119016",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sajit Malla, MD
• Sagar Mallikethi Lepakshi Reddy, M.D.
• Robert Maloney, CRNA
• Pam Malow-Isham
• Eranio U Malto, MD
• Ramadevi Ramalakshmisatya Manam, O.T. R.
• Naishal Dharmeshkumar Mandal
• Shealyn Jade Mandle, MPH
• Eve Rose Mandreky, MA, LPC
• Jeffrey James Mandziuk II, PA-C

• Social Worker in Flint, MI
• Providers in Flint, MI by specialty
• Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2024; 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.