Organization Active NPI

Mallory C Rose

  • Marriage & Family Therapist
  • Northbrook, IL
National Provider Identifier
1962883876
Registry record updated Jun 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
Legal business name
MALLORY C ROSE
Practice address
3305 Robincrest Dr
Northbrook, IL 60062-5126
Phone
(214) 402-7500
NPI assigned
Jun 16, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2015

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

Authorized official

Name
Mallory Cooper Rose, LMFT
Title
Marriage and Family Therapist
Phone
(214) 402-7500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 106H00000X Primary

Addresses

Primary practice location

3305 Robincrest Dr
Northbrook, IL 60062-5126

Mailing address

3305 Robincrest Dr
Northbrook, IL 60062-5126
Phone (214) 402-7500

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1434412800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1434412800000",
    "number": "1962883876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3305 ROBINCREST DR",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600625126",
            "telephone_number": "214-402-7500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3305 ROBINCREST DR",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600625126",
            "telephone_number": "214-402-7500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MALLORY C ROSE",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-16",
        "last_updated": "2015-06-16",
        "status": "A",
        "authorized_official_last_name": "ROSE",
        "authorized_official_first_name": "MALLORY",
        "authorized_official_middle_name": "COOPER",
        "authorized_official_title_or_position": "MARRIAGE AND FAMILY THERAPIST",
        "authorized_official_telephone_number": "214-402-7500",
        "authorized_official_credential": "LMFT"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northbrook, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2015; 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.