Individual provider Active NPI

Mallory Jaymes Hanson, LCSW

  • Clinical Social Worker
  • Norman, OK
National Provider Identifier
1902372311
Registry record updated Nov 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
7826 Issued in OK
Practice address
3700 W Tecumseh Rd Apt 4205
Norman, OK 73072-1852
Phone
(214) 448-5058
NPI assigned
Oct 23, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 66515 TX
Clinical Social Worker 1041C0700X 7826 OK Primary

Addresses

Primary practice location

3700 W Tecumseh Rd Apt 4205
Norman, OK 73072-1852

Mailing address

3700 W Tecumseh Rd Apt 4205
Norman, OK 73072-1852
Phone (214) 448-5058

Other names 1

  • Ms. Mallory Jaymes Beery Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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
I20210415002280 OK Practitioner - Clinical Social Worker 5294143004 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Balance Womens Health LLCGroup PAC ID 3476927740, 89 clinicians

Practice addresses (Care Compare)

1105 SW 30TH CT
Moore, OK 73160-2887
Phone (405) 378-2727

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
66515TXMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Norman Regional Providers Specialty Care CurrentSince Apr 19, 2021 Accepting new patients
Balance Women'S Health, LLC CurrentSince Jul 17, 2023 Accepting new patients
Norman Regional Healthplex Past Accepting new patients

Locations

1113 SW 30th Ct
Moore, OK 73160
Phone (405) 676-8470

1105 SW 30th Ct
Moore, OK 73160
Phone (405) 378-4439

700 S Telephone Rd
Ste 302
Moore, OK 73160
Phone (405) 912-3495

3300 Healthplex Pkwy
Norman, OK 73072
Phone (405) 329-4102

Organizations & group practices 3

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": "1540252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667952000000",
    "number": "1902372311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3700 W TECUMSEH RD APT 4205",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730721852",
            "telephone_number": "214-448-5058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3700 W TECUMSEH RD APT 4205",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730721852",
            "telephone_number": "214-448-5058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANSON",
        "first_name": "MALLORY",
        "middle_name": "JAYMES",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-23",
        "last_updated": "2022-11-09",
        "certification_date": "2022-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "66515",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OK",
            "license": "7826",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MALLORY",
            "last_name": "BEERY",
            "middle_name": "JAYMES",
            "prefix": "MS.",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Norman, OK

Sources for this page

Verify at the official NPI Registry.