MALLORY JOHNSON (NPI# 1093366338) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093366338 |
| Entity Type | Individual |
| Full Name | MALLORY JOHNSON |
| Credential | LPCC |
| Practice Address |
11103 Park Rd Louisville KY 40223-2424 |
| Mailing Address |
4536 S 3rd St Louisville KY 40214-1930 |
| Practice Telephone | 5027535524 |
| Mailing Telephone | 8597602382 |
| Enumeration Date | 2019-09-27 |
| Last Update Date | 2020-09-30 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YM0800X |
Counselor Specialization: Mental Health |
173555 | KY | Behavioral Health & Social Service Providers |
| Y | 101YP2500X |
Counselor Specialization: Professional |
265944 | KY | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972110815 | Mallory Quinn Johnson | Registered Nurse | 449 Kelso Trl, Corbin, KY 40701-8502 | 2020-09-24 |
| 1235456815 | Mallory K Johnson | Speech-Language Pathologist | 4423 Colomba St, Houston, TX 77045-3523 | 2010-04-22 |
| 1265699508 | Mallory Johnson | Nurse Practitioner | 11790 Sw Barnes Rd. Blg A, Ste 140, Portland, OR 97225 | 2008-05-22 |
| 1366081473 | Mallory Claire Johnson | Behavioral Analyst | 225 Cedar Hill St Ste 200, Marlborough, MA 01752-5900 | 2020-01-06 |
| 1518520238 | Mallory Brooke Johnson | Nurse Practitioner | 1718 E 4th St Ste 807, Charlotte, NC 28204-3280 | 2019-04-18 |
| 1407349434 | Mallory Johnson | Counselor | 3322 Broadway Fl 4, Everett, WA 98201-4425 | 2018-06-13 |
| 1790100600 | Mallory Johnson | Counselor | 1921 Ransom Pl, Nashville, TN 37217-3841 | 2014-02-28 |
| 1992034144 | Mallory Marie Johnson | Massage Therapist | 670 Nw Gilman Blvd, Suite #b2, Issaquah, WA 98027-2444 | 2009-12-17 |
| Street Address |
11103 PARK RD |
| City | LOUISVILLE |
| State | KY |
| Zip Code | 40223-2424 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851435705 | Bellewood Presbyterian Home for Children | Residential Treatment Facility, Emotionally Disturbed Children | 11103 Park Rd, Louisville, KY 40223-2424 | 2007-02-16 |
| 1760095954 | Emily Kaelin Stocking | Social Worker | 11103 Park Rd, Louisville, KY 40223-2424 | 2020-08-26 |
| 1275184988 | Amanda Martin | Counselor | 11103 Park Rd, Louisville, KY 40223-2424 | 2019-09-24 |
| 1821649542 | Amanda M. Mullis | Social Worker | 11103 Park Rd, Louisville, KY 40223-2424 | 2019-09-24 |
| 1184004467 | Christine Michelle Taylor Felts | Counselor | 11103 Park Rd, Louisville, KY 40223-2424 | 2015-06-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235605668 | Ashlee Brooke Colville | Counselor | 13121 Esat Point Park Blvd, Suite F, Louisville, KY 40223 | 2018-10-24 |
| 1831619758 | Tracie S Lain | Developmental Therapist | 13101 Eastpoint Park Blvd., Louisville, KY 40223 | 2017-06-21 |
| 1972051399 | Ruby Denise Brooks | Counselor | 1407 Lafontenay Ct, Louisville, KY 40223 | 2016-09-14 |
| 1427409085 | Victoria Krepps Terrell | Nurse Practitioner | 13301 Shelbyville Rd Ste 103, Louisville, KY 40223 | 2016-06-24 |
| 1033570098 | Mackenzie Sipes | Chiropractor | 401 Creason Ct Unit 205, Louisville, KY 40223 | 2016-03-17 |
| 1699151258 | Chelsey Layne Gorham | Marriage & Family Therapist | 13121 Eastpoint Park Blvd Ste F, Louisville, KY 40223 | 2015-08-06 |
| 1356764187 | Paula Renee Garner | Social Worker | 1015 Dorsey Lane, Louisville, KY 40223 | 2014-01-30 |
| 1588086508 | Lori Bettenhausen Williams | Ophthalmology | 1413 Evergreen Rd, Anchorage, KY 40223 | 2014-01-09 |
| 1417392259 | Lauren Parsons Berry | Dentist | 9780 Ormsby Station Rd, Suite 1200, Louisviile, KY 40223 | 2013-05-07 |
| 1336486653 | Lynn M Pendley | Dietitian, Registered | 9400 Mill Brook Rd, Northeast Ymca, Louisville, KY 40223 | 2013-01-07 |
| Find all providers in zip 40223 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922625649 | Laronica Shonta Lawson | Counselor | 17127 Piton Way, Louisville, KY 40245-5409 | 2020-06-29 |
| 1295351724 | Jonathan Yussman | Counselor | 3102 Sunfield Cir, Louisville, KY 40241-6514 | 2020-06-20 |
| 1841811478 | Geneva Marie Drane | Counselor | 4316 Lonsdale Ave, Louisville, KY 40215-1036 | 2020-05-05 |
| 1366082059 | Ramicha T Smith | Counselor | 4602 Southern Pkwy Ste 2c, Louisville, KY 40214-1442 | 2020-01-09 |
| 1558904888 | Sarah Christine Faulkner | Counselor | 3801 Beaufort Ln Apt B, Louisville, KY 40207-4454 | 2019-10-18 |
| 1477101103 | Far Journeys LLC | Counselor | 9720 Bunsen Pkwy, Louisville, KY 40299-1802 | 2019-08-27 |
| 1528615689 | Candace Cooper | Counselor | 214 Breckenridge Ln Ste 203, Louisville, KY 40207-3879 | 2019-08-23 |
| 1760036768 | Rebecca L Roberts-kerns | Counselor | 1936 Gardiner Ln Apt 3, Louisville, KY 40205-2858 | 2019-07-29 |
| 1477110906 | Lauren Muir | Counselor | 1860 Mellwood Ave Ste 117, Louisville, KY 40206-1033 | 2019-05-20 |
| 1851956999 | Christine Smock | Counselor | 700 Front St # 106, Louisville, CO 80027-1805 | 2019-05-03 |
| Find all providers in LOUISVILLE | ||||
| City | LOUISVILLE |
| Zip Code | 40223 |
Please comment or provide details below to improve the information on MALLORY JOHNSON.
| 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.