MS. DEITRA E. BRYANT-MALLORY LICSW, LCSW-C
NPI 1063719060
Social Worker - Clinical in Lanham, MD
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
Specialties & Licenses
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).
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.
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 weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.