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NPI Code Detail

MEDICARE: MS. GRACE FRIEDEN O'MALLEY MSW

MEDICARE: MS. GRACE FRIEDEN O'MALLEY MSW
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
1104100000XSocial Worker
2171M00000XCase Manager/Care Coordinator
31041C0700XClinical Social Worker149029881IL

General Provider Information

NPI Number : 1881162899
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. GRACE FRIEDEN O'MALLEY MSW
Provider Business Mailing Address
First Line : 350 GATEWAY DR
Second Line :
City : SLIDELL
State : LA
Zip : 70461-5589
Country : US
Telephone Number : 985-707-1410
Fax Number : 985-707-1415
Provider Business Practice Location Address
First Line : 350 GATEWAY DR
Second Line :
City : SLIDELL
State : LA
Zip : 70461-5589
Country : US
Telephone Number : 985-707-1410
Fax Number : 985-707-1415
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/07/2018
Last Update Date : 06/27/2026

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