Active NPI
Mallorie Taylor Lara, LICSW
- Clinical Social Worker
- Manchester, NH
National Provider Identifier
1851983274
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 3000
- Practice address
- 149 Hanover St Ste 200
Manchester, NH 03101-2245 - Phone
- (603) 696-4872
- NPI assigned
- Feb 8, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 12111273-3501 | UT | |
| Social Worker | 104100000X | 12111273-3502 | UT | |
| Clinical Social Worker | 1041C0700X | 3000 | NH | Primary |
Addresses
Primary practice location
149 Hanover St Ste 200
Manchester, NH 03101-2245
Mailing address
149 Hanover St Ste 200
Manchester, NH 03101-2245
Phone (603) 696-4872
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 |
|---|---|---|---|
| 12111273-3502 | UT | MD | Social Worker |
| 3000 | NH | MD | Clinical Social Worker |
| 12111273-3501 | UT | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1612742400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1737676800000",
"number": "1851983274",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "149 HANOVER ST STE 200",
"city": "MANCHESTER",
"state": "NH",
"postal_code": "031012245",
"telephone_number": "603-696-4872"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "149 HANOVER ST STE 200",
"city": "MANCHESTER",
"state": "NH",
"postal_code": "031012245",
"telephone_number": "603-696-4872"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LARA",
"first_name": "MALLORIE",
"middle_name": "TAYLOR",
"name_prefix": "Mrs.",
"credential": "LICSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-02-08",
"last_updated": "2025-01-24",
"certification_date": "2025-01-24",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "UT",
"license": "12111273-3501",
"primary": false
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "UT",
"license": "12111273-3502",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NH",
"license": "3000",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Manchester, NH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 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.