Kathryn Chatterton Mallory, LPS

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

135481 Issued in AK

Practice address

318 Slater St
Fairbanks, AK 99701-2923

Phone

(907) 457-1101

Fax

(907) 457-1121

NPI assigned

Jun 5, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1528156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553731200000",
    "number": "1922590918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "318 SLATER ST",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997012923",
            "telephone_number": "907-457-1101",
            "fax_number": "907-457-1121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "318 SLATER ST",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997012923",
            "telephone_number": "907-457-1101",
            "fax_number": "907-457-1121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALLORY",
        "first_name": "KATHRYN",
        "middle_name": "CHATTERTON",
        "name_prefix": "Mrs.",
        "credential": "LPS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-06-05",
        "last_updated": "2019-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AK",
            "license": "135481",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1596091",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Making a Difference Support Services, LLC
• Liza Sarah Malamute, RN, CDE, CFCN
• Jedidiah Jonah Malan, MD
• Sara DB Malenfant, LMT
• Alejandrina Maria Mallet, RBT
• Christine M. Malone, RN, BSN, MSPH
• Natosha Malone, MSW
• Alyona A Malyk
• Natalia Malyk, LMT
• Nina F Malyk, BT

• Mental Health Counselor in Fairbanks, AK
• Providers in Fairbanks, AK by specialty
• Mental Health Counselor in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2019; 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.