LATASHA TENE MALLORY
NPI 1689566184
Social Worker - Clinical in Chicago, IL

Q: What is Latasha Mallory's NPI number?

The NPI number for Latasha Mallory is 1689566184. It was assigned to this individual provider in the NPPES registry on July 18, 2025.

Q: What is Latasha Mallory's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Latasha Mallory was last updated on July 18, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.

Active since July 18, 2025PECOS EnrolledAccepts Medicare Assignment

303 E WACKER DR STE 1127, CHICAGO, IL 60601(312) 736-1776 Get Directions Write a Review

NPPES record last updated: July 18, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Latasha Tene Mallory NPPES

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

LATASHA TENE MALLORY (NPI 1689566184) is an individual clinical provider in Chicago, Illinois, licensed in Illinois (180005020) and active in the NPI registry since July 2025. She is enrolled in Medicare PECOS and is a graduate of Other (1999).

NPPES Registry Identity

NPI1689566184

Entity TypeIndividualFemale

Primary Taxonomy1041C0700X

Provider Legal NameLATASHA TENE MALLORY

Location Address303 E WACKER DR STE 1127Chicago, IL 60601-5215

Mailing Address605 S 9th AveMaywood, IL 60153-1530 · (708) 227-5159

Phone(312) 736-1776

Sole ProprietorYes

Medical School CMSOtherGraduated 1999

Enumeration DateJuly 18, 2025

NPPES CertifiedJuly 17, 2025

✔ NPI 1689566184 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code1041C0700X

License✔ Licensed in IL · 180005020

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.

303 E WACKER DR STE 1127, Chicago, IL 60601

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Providence Health Plan.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Latasha Tene Mallory is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID6002316569

PECOS Enrollment IDI20250820003675

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 60601 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 $60.08 – $183.39

Typical copayment $0.00 (range $15.02 – $45.84)

Most-billed visit code NA

Established Patient

$74.80 typical visit price

range $18.97 – $148.12

Typical copayment $18.70 (range $4.74 – $37.03)

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.

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

NANCY SARADZAYI MHANGAMI NP

Nurse Practitioner (Primary Care)