Tamika Mallard I, SOCIAL WORKER, BS

Primary specialty

CounselorTaxonomy code 101Y00000X

Practice address

800 W Oakland Park Blvd
Wilton Manors, FL 33311-0916

Phone

(754) 701-1197

NPI assigned

Dec 16, 2014

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 names 1

• Tamika Mallard Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor of Science

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

{
    "created_epoch": "1418688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418688000000",
    "number": "1861890246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3009 NW 7TH ST",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333117611",
            "telephone_number": "754-201-9855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 W OAKLAND PARK BLVD",
            "city": "WILTON MANORS",
            "state": "FL",
            "postal_code": "333110916",
            "telephone_number": "754-701-1197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALLARD",
        "first_name": "TAMIKA",
        "name_suffix": "I",
        "credential": "SOCIAL WORKER, BS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-12-16",
        "last_updated": "2014-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TAMIKA",
            "last_name": "MALLARD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Counselor in Wilton Manors, FL
• Providers in Wilton Manors, FL by specialty
• Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 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.