Active NPI
Mallorie Ely, LCSW
- Social Worker
- Sandpoint, ID
National Provider Identifier
1871925834
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- LCSW35962
- Practice address
- 1009 Highway 2 Ste D
Sandpoint, ID 83864-2713 - Phone
- (208) 610-0996
- Fax
- (208) 625-2046
- NPI assigned
- Aug 1, 2013
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | LCSW35962 | ID | Primary |
Addresses
Primary practice location
1009 Highway 2 Ste D
Sandpoint, ID 83864-2713
Mailing address
PO Box 484
Kootenai, ID 83840-0484
Phone (208) 610-0996
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in ID
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
1009 Hwy 2
Suite D
Sandpoint, ID 83864-2713
Phone (208) 610-0996
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LCSW35962 | ID | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mallorie Ely, LLC | Current | Accepting new patients |
Locations
1009 Highway 2
Ste D
Sandpoint, ID 83864
Phone (208) 290-2457
Organizations & group practices 1
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.
-
- Community/Behavioral Health Agency
- Sandpoint, ID
- NPI 1649818642
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1375315200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1691452800000",
"number": "1871925834",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 484",
"city": "KOOTENAI",
"state": "ID",
"postal_code": "838400484",
"telephone_number": "208-610-0996"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1009 HIGHWAY 2 STE D",
"city": "SANDPOINT",
"state": "ID",
"postal_code": "838642713",
"telephone_number": "208-610-0996",
"fax_number": "208-625-2046"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELY",
"first_name": "MALLORIE",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-08-01",
"last_updated": "2023-08-08",
"certification_date": "2023-08-08",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "ID",
"license": "LCSW35962",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sandpoint, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.