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General NPI Number Information
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NPI Number | 1760093710
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Entity Type | Individual
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Provider Name | CARA A MALLON LCSW
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Gender | Female
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Dates
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Enumeration Date | 08/13/2020
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Last Update Date | 02/11/2022
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Provider Practice Location Address
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Address Line | 1400 BLACKHORSE HILL RD
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City | COATESVILLE
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State | PA
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Zip | 19320-2096
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Country | US
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Telephone | 484-545-8950
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Fax | 610-466-2263
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Provider Business Mailing Address
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Address Line | 918 HENNING RD
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City | PERKIOMENVILLE
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State | PA
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Zip | 18074-9553
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Country | US
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Telephone | 215-605-1708
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | CW021172
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License Number State | PA
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