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General NPI Number Information
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NPI Number | 1821227604
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Entity Type | Individual
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Provider Name | MARY ANN OMALLOY LPCC
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Gender | Female
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Dates
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Enumeration Date | 07/14/2009
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Last Update Date | 05/27/2025
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Provider Practice Location Address
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Address Line | 10200 ALLIANCE RD STE 150
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City | BLUE ASH
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State | OH
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Zip | 45242-4754
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Country | US
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Telephone | 216-468-5000
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Fax |
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Provider Business Mailing Address
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Address Line | 4800 N SCOTTSDALE RD STE 2500
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City | SCOTTSDALE
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State | AZ
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Zip | 85251-7630
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Country | US
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Telephone | 216-468-5000
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 943881
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 111NI0900X
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Taxonomy Name | Internist Chiropractor
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License Number | 3419
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | E.0004951-SUPV
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License Number State | OH
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