MS. DEITRA E. BRYANT-MALLORY LICSW, LCSW-C
NPI 1063719060
Social Worker - Clinical in Lanham, MD

Active since February 28, 2011PECOS Enrolled
10001 DEREKWOOD LN STE 120, LANHAM, MD 20706(301) 306-4590 Get Directions Write a Review

NPPES record last updated: May 22, 2026. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Ms. Deitra E. Bryant-mallory Licsw, Lcsw-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MS. DEITRA E. BRYANT-MALLORY LICSW, LCSW-C (NPI 1063719060) is an individual clinical provider in Lanham, Maryland, licensed in Maryland (13673) and active in the NPI registry since February 2011. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1063719060
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameMS. DEITRA E. BRYANT-MALLORYCredential: LICSW, LCSW-C
Location Address10001 DEREKWOOD LN STE 120Lanham, MD 20706-4876
Mailing Address4014 Wales LnUpper Marlboro, MD 20772-7997 · (240) 462-9283
Sole ProprietorYes
Enumeration DateFebruary 28, 2011
Last NPPES UpdateMay 22, 2026
NPPES CertifiedMay 22, 2026
NPI 1063719060 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
Licenses Licensed in MD · 13673 Licensed in DC · LC50078061
Definition

A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.

10001 DEREKWOOD LN STE 120, Lanham, MD 20706

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare (PECOS)

Ms. Deitra E. Bryant-mallory Licsw, Lcsw-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 20706 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$0.00 typical visit price
range $65.18 – $194.86
Typical copayment $0.00 (range $16.29 – $48.71)
Most-billed visit code NA
Established Patient
$80.66 typical visit price
range $21.40 – $158.88
Typical copayment $20.16 (range $5.35 – $39.72)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Deitra Bryant-mallory's NPI number?

The NPI number for Deitra Bryant-mallory is 1063719060. It was assigned to this individual provider in the NPPES registry on February 28, 2011.

Where is Deitra Bryant-mallory located?

Deitra Bryant-mallory practices at 10001 Derekwood Ln Ste 120, Lanham, MD 20706. The listed phone number is (301) 306-4590.

What is Deitra Bryant-mallory's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Is Deitra Bryant-mallory enrolled in Medicare?

Yes. Deitra Bryant-mallory is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Deitra Bryant-mallory was last updated on May 22, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.