Individual provider Active NPI

Maryann Malena, LCSW

  • Clinical Social Worker
  • Atlanta, GA
National Provider Identifier
1982473740
Registry record updated Jun 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW008667 Issued in GA
Practice address
45 Ivan Allen Jr Blvd NW Unit 1908
Atlanta, GA 30308-3060
Phone
(718) 810-6384
NPI assigned
Dec 21, 2023
Last updated
Jun 9, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 9, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X CSW008667 GA Primary

Addresses

Primary practice location

45 Ivan Allen Jr Blvd NW Unit 1908
Atlanta, GA 30308-3060

Mailing address

45 Ivan Allen Jr Blvd NW Unit 1908
Atlanta, GA 30308-3060
Phone (718) 810-6384

Other practice location 1

2504 Camino Entrada
Santa Fe, NM 87507-4851
Phone (505) 216-2727

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
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
I20250708001908 NM Practitioner - Clinical Social Worker 5698289114 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

2504 Camino Entrada
Santa Fe, NM 87507-4851
Phone (505) 216-2727

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CSW008667GAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Teambuilders Behavioral Health, LLC CurrentSince Jul 1, 2025 Accepting new patients
Teambuilders Behavioral Health, LLC CurrentSince Jul 1, 2025 Accepting new patients
Teambuilders Behavioral Health, LLC Clinical Current Accepting new patients

Locations

2504 Camino Entrada
Santa Fe, NM 87507
Phone (505) 216-2727

105 Paseo del Canon W
Taos, NM 87571
Phone (575) 751-7037

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1703116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749427200000",
    "number": "1982473740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 IVAN ALLEN JR BLVD NW UNIT 1908",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303083060",
            "telephone_number": "718-810-6384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 IVAN ALLEN JR BLVD NW UNIT 1908",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303083060",
            "telephone_number": "718-810-6384"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2504 Camino Entrada",
            "address_purpose": "LOCATION",
            "city": "Santa Fe",
            "state": "NM",
            "postal_code": "875074851",
            "country_code": "US",
            "telephone_number": "505-216-2727",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MALENA",
        "first_name": "MARYANN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-12-21",
        "last_updated": "2025-06-09",
        "certification_date": "2025-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW008667",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.