Individual provider Active NPI

Emily Mallobe

  • Clinical Social Worker
  • Charlotte, NC
National Provider Identifier
1790581387
Registry record updated Feb 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
P021558 Issued in NC
Practice address
325 Matthews-Mint Hill Rd
Suite 103
Charlotte, NC 28025
Phone
(704) 900-2904
NPI assigned
Feb 24, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 24, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X P021558 NC Primary

Addresses

Primary practice location

325 Matthews-Mint Hill Rd
Suite 103
Charlotte, NC 28025

Mailing address

5624 Kildare Dr
Charlotte, NC 28215-2425
Phone (704) 299-7513

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

LicenseStateTypeSpecialty
P021558NCMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1740355200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740355200000",
    "number": "1790581387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5624 KILDARE DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282152425",
            "telephone_number": "704-299-7513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 MATTHEWS-MINT HILL RD",
            "address_2": "SUITE 103",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "28025",
            "telephone_number": "704-900-2904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALLOBE",
        "first_name": "EMILY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-02-24",
        "last_updated": "2025-02-24",
        "certification_date": "2025-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P021558",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 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.