Individual provider Active NPI

Mallory Kleps

  • Clinical Social Worker
  • Wampsville, NY
National Provider Identifier
1871157065
Registry record updated Aug 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
095974 Issued in NY
Practice address
138 N Court St
Wampsville, NY 13163
Phone
(315) 366-2327
NPI assigned
Apr 24, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X
Clinical Social Worker 1041C0700X
Clinical Social Worker 1041C0700X 095974 NY Primary

Addresses

Primary practice location

138 N Court St
Wampsville, NY 13163

Mailing address

138 N Court St
Wampsville, NY 13163-0608
Phone (315) 366-2327

Other practice location 1

624 Elizabeth St
Utica, NY 13501-2413
Phone (315) 272-2600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20230929000338 NY Practitioner - Clinical Social Worker 9234583949 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Madison CountyGroup PAC ID 2365335957, 11 clinicians

Practice addresses (Care Compare)

138 N Court St
Wampsville, NY 13163-0608
Phone (315) 366-2327

N Court St
PO Box 608
Wampsville, NY 13163-0608

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
095974NYMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Madison County CurrentSince Aug 18, 2023 Accepting new patients
The Neighborhood Center, Inc. Clinical PastSince Dec 24, 2023 Accepting new patients

Locations

138 N Court St
#B
Wampsville, NY 13163

138 N Court St
Wampsville, NY 13163
Phone (315) 366-2788

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1556064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692748800000",
    "number": "1871157065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "138 N COURT ST",
            "city": "WAMPSVILLE",
            "state": "NY",
            "postal_code": "131630608",
            "telephone_number": "315-366-2327"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "138 N COURT ST",
            "city": "WAMPSVILLE",
            "state": "NY",
            "postal_code": "13163",
            "telephone_number": "315-366-2327"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "624 Elizabeth St",
            "address_purpose": "LOCATION",
            "city": "Utica",
            "state": "NY",
            "postal_code": "135012413",
            "country_code": "US",
            "telephone_number": "315-272-2600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KLEPS",
        "first_name": "MALLORY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-24",
        "last_updated": "2023-08-23",
        "certification_date": "2023-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "095974",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wampsville, NY

Sources for this page

Verify at the official NPI Registry.