Mallory Lynne Sutphin, LCPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LC5474 Issued in MD

Practice address

59 Kate Wagner Rd
Westminster, MD 21157-6957

Phone

(443) 244-8642

Fax

(410) 876-3016

NPI assigned

Oct 17, 2014

Last updated

Oct 17, 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 names 1

• Mallory Beall Former name

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": "1413504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1413504000000",
    "number": "1801290028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "59 KATE WAGNER RD",
            "city": "WESTMINSTER",
            "state": "MD",
            "postal_code": "211576957",
            "telephone_number": "443-244-8642",
            "fax_number": "410-876-3016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "59 KATE WAGNER RD",
            "city": "WESTMINSTER",
            "state": "MD",
            "postal_code": "211576957",
            "telephone_number": "443-244-8642",
            "fax_number": "410-876-3016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUTPHIN",
        "first_name": "MALLORY",
        "middle_name": "LYNNE",
        "credential": "LCPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-17",
        "last_updated": "2014-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MD",
            "license": "LC5474",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MALLORY",
            "last_name": "BEALL",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Professional Counselor in Westminster, MD
• Providers in Westminster, MD by specialty
• Professional Counselor in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 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.