Individual provider Active NPI

Ryann Anne Mallonee, LCSW

  • Clinical Social Worker
  • Liberty, MO
National Provider Identifier
1851671051
Registry record updated Oct 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
2009009730 Issued in MO
Practice address
6 Victory LN
Ste 102
Liberty, MO 64068-2395
Phone
(816) 678-1420
NPI assigned
Aug 19, 2011
Last updated
Oct 20, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 20, 2016

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 2009009730 MO Primary

Addresses

Primary practice location

6 Victory LN
Ste 102
Liberty, MO 64068-2395

Mailing address

12577 State Route 92
Kearney, MO 64060
Phone (816) 678-1420

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120220000031 MO Practitioner - Clinical Social Worker 2264690437 Practice locations: Liberty, MO

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

6 Victory Dr
Suite 102
Liberty, MO 64068-1972
Phone (816) 678-1420

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1313712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476921600000",
    "number": "1851671051",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12577 STATE ROUTE 92",
            "city": "KEARNEY",
            "state": "MO",
            "postal_code": "64060",
            "telephone_number": "816-678-1420",
            "fax_number": "816-533-4106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 VICTORY LN",
            "address_2": "STE 102",
            "city": "LIBERTY",
            "state": "MO",
            "postal_code": "640682395",
            "telephone_number": "816-678-1420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALLONEE",
        "first_name": "RYANN",
        "middle_name": "ANNE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-08-19",
        "last_updated": "2016-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2009009730",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Liberty, MO

Sources for this page

Verify at the official NPI Registry.