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NPI Code Detail

MEDICARE: MALLORY VALVERDE LCSW

MEDICARE:   MALLORY  VALVERDE  LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1NAOTHERNA
2NAOTHERN/A

General Provider Information

NPI Number : 1316571201
Entity Type Code : Individual
Provider Name (Legal Business Name) : MALLORY VALVERDE LCSW
Provider Business Mailing Address
First Line : 8140 GLORY DR
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80924-4477
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 9723 NORTHEAST PKWY STE 100
Second Line :
City : MATTHEWS
State : NC
Zip : 28105-9719
Country : US
Telephone Number : 719-305-1234
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/28/2020
Last Update Date : 05/30/2025

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Directions to “ MALLORY VALVERDE LCSW” Practice Location

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