Shahauna Latia Mallery, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

0024186470 Issued in VA

Practice address

238 Battlefield Blvd S Ste 200
Chesapeake, VA 23322-5233

Phone

(757) 330-2491

Fax

(757) 974-0041

NPI assigned

Feb 8, 2023

Last updated

Aug 25, 2025By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective May 30, 2023 through May 30, 2027

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Dragonfly Counseling and Consulting

  • Mental Health Counselor
  • Chesapeake, VA
  • NPI 1487370003
  NPD (past)

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

{
    "created_epoch": "1675814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756080000000",
    "number": "1861199184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "238 BATTLEFIELD BLVD S STE 200",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233225233",
            "telephone_number": "757-330-2491",
            "fax_number": "757-974-0041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "238 BATTLEFIELD BLVD S STE 200",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233225233",
            "telephone_number": "757-330-2491",
            "fax_number": "757-974-0041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALLERY",
        "first_name": "SHAHAUNA",
        "middle_name": "LATIA",
        "credential": "PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-02-08",
        "last_updated": "2025-08-25",
        "certification_date": "2025-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "VA",
            "license": "0024186470",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VIRGINIA DEPARTMENT OF HEALTH PROFESSIONS",
            "identifier": "0001227876",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VIRGINIA DEPARTMENT OF HEALTH PROFESSIONS",
            "identifier": "0024186470",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Walid Fuad Makdisi, M.D.
• Anitha Malaisamy, M.D.
• Kerry Maldiner, LMFT
• Erin Malicek
• Fouad Malki, DDS
• Ross A. Malley, MD
• Tiara Mallory, RBT
• Arlene Malone, PH.D., LPC, NCC
• Alyssa Malvinni, LMT
• Cristie Tamar Mangrum

• Psychiatric/Mental Health Nurse Practitioner in Chesapeake, VA
• Providers in Chesapeake, VA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.