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MALLORY ANTONETTA WILSON SUDA
NPI 1730923699
Counselor - Addiction (Substance Use Disorder) in Twin Falls, ID

Active since June 24, 2024
630 ADDISON AVE W STE 1000, TWIN FALLS, ID 83301(208) 736-5048 Get Directions Write a Review

NPPES record last updated: June 24, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Mallory Antonetta Wilson Suda NPPES

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

MALLORY ANTONETTA WILSON SUDA (NPI 1730923699) is an individual addiction (substance use disorder) provider in Twin Falls, Idaho, licensed in Idaho (13044) and active in the NPI registry since June 2024.

NPPES Registry Identity

NPI1730923699
Entity TypeIndividualFemale
Primary Taxonomy101YA0400X
Provider Legal NameMALLORY ANTONETTA WILSONCredential: SUDA
Location Address630 ADDISON AVE W STE 1000Twin Falls, ID 83301-5853
Mailing Address630 Addison Ave W Ste 1000Twin Falls, ID 83301-5853 · (208) 736-5048
Phone(208) 736-5048
Sole ProprietorNo
Enumeration DateJune 24, 2024
NPPES CertifiedJune 24, 2024
✔ NPI 1730923699 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers
Taxonomy Code101YA0400X
License✔ Licensed in ID · 13044
630 ADDISON AVE W STE 1000, Twin Falls, ID 83301
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Other Providers at the Same Location NPPES 15

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

STEPHANIE LYNN CALLEN LSW
Counselor (Addiction (Substance Use Disorder))
630 ADDISON AVE W STE 1000
TWIN FALLS, ID 83301
Twin Falls County (208) 736-5048
JESSICA ROWE LSW
Social Worker
630 ADDISON AVE W STE 1000
TWIN FALLS, ID 83301
Twin Falls County (208) 736-5048
KIM L GRATA CADC
Counselor (Addiction (Substance Use Disorder))
630 ADDISON AVE W STE 1000
TWIN FALLS, ID 83301
Twin Falls County (208) 736-5048
PAUL DAVID GUYMON LMSW
Counselor (Addiction (Substance Use Disorder))
630 ADDISON AVE W STE 1000
TWIN FALLS, ID 83301
Twin Falls County (208) 736-5048
DUSTIN BURSON MOORE
Counselor (Mental Health)
630 ADDISON AVE W STE 1000
TWIN FALLS, ID 83301
Twin Falls County (208) 736-5048
KRISTINA BUNN LSW
Social Worker
630 ADDISON AVE W STE 1000
TWIN FALLS, ID 83301
Twin Falls County (208) 736-5048
JEREMY AJETI BS
Case Management
630 ADDISON AVE W STE 1000
TWIN FALLS, ID 83301
Twin Falls County (208) 736-5048
TWIN FALLS COUNTY
Community/Behavioral Health
630 ADDISON AVE W STE 1000
TWIN FALLS, ID 83301
Twin Falls County (208) 736-5048

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 Mallory Wilson's NPI number?

The NPI number for Mallory Wilson is 1730923699. It was assigned to this individual provider in the NPPES registry on June 24, 2024.

Where is Mallory Wilson located?

Mallory Wilson practices at 630 Addison Ave W Ste 1000, Twin Falls, ID 83301. The listed phone number is (208) 736-5048.

What is Mallory Wilson's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Addiction (Substance Use Disorder), with taxonomy code 101YA0400X.

When was this NPI record last updated?

The NPPES record for Mallory Wilson was last updated on June 24, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years 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.