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NPI Code Detail

MEDICARE: MARY ANN OMALLOY LPCC

MEDICARE:   MARY ANN  OMALLOY  LPCC
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
1101YA0400XAddiction (Substance Use Disorder) Counselor943881OH
2111NI0900XInternist Chiropractor3419OH
3101YP2500XProfessional CounselorE.0004951-SUPVOH

General Provider Information

NPI Number : 1821227604
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARY ANN OMALLOY LPCC
Provider Business Mailing Address
First Line : 4800 N SCOTTSDALE RD STE 2500
Second Line :
City : SCOTTSDALE
State : AZ
Zip : 85251-7630
Country : US
Telephone Number : 216-468-5000
Fax Number :
Provider Business Practice Location Address
First Line : 10200 ALLIANCE RD STE 150
Second Line :
City : BLUE ASH
State : OH
Zip : 45242-4754
Country : US
Telephone Number : 216-468-5000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/14/2009
Last Update Date : 05/27/2025

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Directions to “ MARY ANN OMALLOY LPCC” Practice Location

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