Individual provider Active NPI

Mallory Rose Martire, LCSW

  • Clinical Social Worker
  • Carmel, NY
National Provider Identifier
1902449200
Registry record updated Jan 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
101633 Issued in NY
Practice address
667 Stoneleigh Ave Ste 202
Carmel, NY 10512-2455
Phone
(845) 279-5908
NPI assigned
Oct 20, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 114331 NY
Clinical Social Worker 1041C0700X 101633 NY Primary

Addresses

Primary practice location

667 Stoneleigh Ave Ste 202
Carmel, NY 10512-2455

Mailing address

667 Stoneleigh Ave Ste 202
Carmel, NY 10512-2455
Phone (845) 279-5908

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
I20260225000641 NY Practitioner - Clinical Social Worker 9133600406 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2021
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

4800 N Scottsdale Rd
Suite 2500
Scottsdale, AZ 85251-7630

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
114331NYMDSocial Worker
101633NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Carmel Psychological Health, PC Clinical CurrentSince Jan 18, 2026 Accepting new patients

Locations

667 Stoneleigh Ave
Ste 202
Carmel, NY 10512
Phone (845) 278-5223

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.

NPI Registry JSON

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

{
    "created_epoch": "1571529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769644800000",
    "number": "1902449200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "667 STONELEIGH AVE STE 202",
            "city": "CARMEL",
            "state": "NY",
            "postal_code": "105122455",
            "telephone_number": "845-279-5908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "667 STONELEIGH AVE STE 202",
            "city": "CARMEL",
            "state": "NY",
            "postal_code": "105122455",
            "telephone_number": "845-279-5908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIRE",
        "first_name": "MALLORY",
        "middle_name": "ROSE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-20",
        "last_updated": "2026-01-29",
        "certification_date": "2026-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "114331",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "101633",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carmel, NY

Sources for this page

Verify at the official NPI Registry.