Kelly S Malloch, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Practice address

9 Roslyn Dr
Ballston Lake, NY 12019-9744

Phone

(518) 378-6390

NPI assigned

Dec 6, 2007

Last updated

Jan 11, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1196899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610323200000",
    "number": "1972786432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 ROSLYN DR",
            "city": "BALLSTON LAKE",
            "state": "NY",
            "postal_code": "120199744",
            "telephone_number": "518-378-6390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 ROSLYN DR",
            "city": "BALLSTON LAKE",
            "state": "NY",
            "postal_code": "120199744",
            "telephone_number": "518-378-6390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALLOCH",
        "first_name": "KELLY",
        "middle_name": "S",
        "name_prefix": "Mrs.",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-06",
        "last_updated": "2021-01-11",
        "certification_date": "2021-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Ballston Lake, NY
• Providers in Ballston Lake, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2021; 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.