DR. CHARLES J. MALLO (NPI# 1063611788) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1063611788 |
Entity Type | Individual |
Full Name | DR. CHARLES J. MALLO |
Credential | DO |
Practice Address |
216 Vaughan St Portland ME 04102-3204 |
Mailing Address |
78 Atlantic Pl South Portland ME 04106-2316 |
Practice Telephone | 2076624480 |
Practice Fax Number | 2076623262 |
Mailing Telephone | 2076616654 |
Mailing Fax Number | 2078427773 |
Enumeration Date | 2007-07-12 |
Last Update Date | 2016-12-07 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
DO2378 | ME | Allopathic & Osteopathic Physicians |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1558333492 | Charles J. Mallo | Specialist | 988 Oak Ridge Tpke, Suite 350, Oak Ridge, TN 37830-6930 | 2006-02-05 |
Street Address |
216 VAUGHAN ST |
City | PORTLAND |
State | ME |
Zip Code | 04102-3204 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1700861101 | Bryan E Woods | Psychiatry & Neurology | 216 Vaughan St, Portland, ME 04102-3204 | 2005-12-08 |
1659880748 | Hayley Gabrielle Fitzgerald | Social Worker | 216 Vaughan St, Portland, ME 04102-3204 | 2017-09-21 |
1235665993 | Sherene Salahshoor | Social Worker | 216 Vaughan St, Portland, ME 04102-3204 | 2017-05-02 |
1518321462 | Kara Stuhr | Psychiatry & Neurology | 216 Vaughan St, Portland, ME 04102-3204 | 2016-04-06 |
1104204825 | Kathleen Sprengel | Social Worker | 216 Vaughan St, Portland, ME 04102-3204 | 2015-05-14 |
1922491562 | Julia Mw Foster | Counselor | 216 Vaughan St, Portland, ME 04102-3204 | 2015-03-06 |
1821387218 | Raymond Serrano | Psychiatry & Neurology | 216 Vaughan St, Portland, ME 04102-3204 | 2011-04-06 |
1326342809 | Rebecca Jaynes | Counselor | 216 Vaughan St, Portland, ME 04102-3204 | 2010-12-27 |
1427366517 | Rebecca M Wertheimer | Social Worker | 216 Vaughan St, Portland, ME 04102-3204 | 2010-09-22 |
1841427671 | Leah K Bauer | Psychiatry & Neurology | 216 Vaughan St, Portland, ME 04102 | 2009-06-19 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1720602964 | Ci Yen Joanna Man | Student in an Organized Health Care Education/Training Program | 190 Park Ave., Portland, ME 04102 | 2020-06-03 |
1841811338 | Abby Zarotny Sahagian | Nurse Anesthetist, Certified Registered | Mmc Anesthesia and Perioperative Medicine, 22 Bramhall St, Portland, ME 04102 | 2020-05-06 |
1124656863 | Zachary Bernard Tillett | Student in an Organized Health Care Education/Training Program | Maine Medical Center 22 Bramhall St., Portland, ME 04102 | 2020-03-30 |
1215564323 | Joshua Allen Swenson | Student in an Organized Health Care Education/Training Program | 33 Bramhall St, Portland, ME 04102 | 2020-03-26 |
1740776434 | Rishi Phakey | Dentist | Community Dental, 190 Park Ave, Portland, ME 04102 | 2018-07-05 |
1982192571 | Jessica Thomas | Doula | 619 Brighton Ave #101, Rosemont Wellness Center, Portland, ME 04102 | 2018-04-29 |
1699270744 | Shane D Kirkegaard | Student in an Organized Health Care Education/Training Program | Maine Medical Center 22 Bramhall Street, Portland, ME 04102 | 2018-03-29 |
1144752494 | Al-shawk Home Healthcare, LLC | Technician | 640 Brighton Ave Ste 8, Portland, ME 04102 | 2017-03-28 |
1376074674 | Samuel B Potter | Emergency Medicine | Maine Medical Center, 22 Bramhall Street, Portland, ME 04102 | 2017-03-27 |
1043767536 | Kevin De Ruiter | Social Worker | 129 Pine St Apt 6, Portland, ME 04102 | 2016-09-01 |
Find all providers in zip 04102 |
Taxonomy Code | 2084P0800X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Psychiatry & Neurology |
Specialization | Psychiatry |
A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems. |
Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1447878947 | Celia Mantovani | Psychiatry & Neurology | 15 Cypress St, Portland, ME 04103-2008 | 2020-07-10 |
1538782834 | Endeavor Psychiatry LLC | Psychiatry & Neurology | Sw, Portland, OR 97219-5885 | 2020-05-20 |
1154942142 | Prisma Wellness LLC | Psychiatry & Neurology | 10260 Sw Greenburg Rd Fl 4, Portland, OR 97223-5500 | 2020-04-30 |
1588291082 | Alexis Family Psychiatry, LLC | Psychiatry & Neurology | 415 Congress St Ste 202a, Portland, ME 04101-3500 | 2020-03-24 |
1881188084 | Geriatric Psychiatry Associates | Psychiatry & Neurology | 123 Nw 12th Ave Apt 424, Portland, OR 97209-4145 | 2018-06-20 |
1982104063 | Carl Chi | Psychiatry & Neurology | 22 Goodrich Ln, Portland, CT 06480-1063 | 2018-02-15 |
1154839108 | Cascade Tms LLC | Psychiatry & Neurology | 205 Se Spokane St Ste 301, Portland, OR 97202-6487 | 2018-01-11 |
1538601737 | Diana S Domnitei Md LLC | Psychiatry & Neurology | 1012 Sw King Ave Ste 306, Portland, OR 97205-1110 | 2016-11-06 |
1104286269 | Anne Fleming, Md, LLC | Psychiatry & Neurology | 2340 Nw Thurman St Ste 202, Portland, OR 97210-2579 | 2016-03-02 |
1417338708 | Andrew Justin Ruege | Psychiatry & Neurology | 5421 Sw Patton Rd, Portland, OR 97221-2226 | 2015-06-12 |
Find all providers in PORTLAND |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.