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General NPI Number Information
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NPI Number | 1497467294
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Entity Type | Organization
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Legal Business Name | MALLORY L CARY
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Dates
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Enumeration Date | 12/23/2022
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Last Update Date | 07/25/2025
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Provider Practice Location Address
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Address Line | 610 KENTUCKY ST
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City | SCOTTDALE
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State | GA
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Zip | 30079-1124
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Country | US
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Telephone | 770-276-9983
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 190905
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City | BROOKHAVEN
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State | GA
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Zip | 31119
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Country | US
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Telephone | 770-237-9983
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Fax | 833-811-8331
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Authorized Official
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Title or Position | OWNER
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Name | MALLORY CARY
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Credential | LCSW
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Telephone | 678-472-3131
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 171400000X
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Taxonomy Name | Health & Wellness Coach
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 364SP0808X
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Taxonomy Name | Psychiatric/Mental Health Clinical Nurse Specialist
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License Number |
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License Number State |
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