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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

MALLORY TEDRICK LISW
NPI 1780319525
Social Worker - Clinical in Lakewood, OH

Active since July 17, 2022Opted out of Medicare · through Jul 1, 2027
18123 SLOANE AVE STE 3, LAKEWOOD, OH 44107(440) 782-1117 Get Directions Write a Review

NPPES record last updated: July 28, 2026. Verified against the NPPES registry weekly; last sync: August 30, 2026.

Record update history: Jul 28, 2026, Mar 3, 2025, Jul 17, 2022 (3 updates tracked since 2022).

About Mallory Tedrick Lisw NPPES

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

MALLORY TEDRICK LISW (NPI 1780319525) is an individual clinical provider in Lakewood, Ohio, licensed in Ohio (I.2506260) and active in the NPI registry since July 2022. She has opted out of Medicare through July 1, 2027.

NPPES Registry Identity

NPI1780319525
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameMALLORY TEDRICKCredential: LISW
Location Address18123 SLOANE AVE STE 3Lakewood, OH 44107-3107
Mailing Address20400 Lake RdRocky River, OH 44116-1330 · (440) 728-7590
Phone(440) 782-1117
Sole ProprietorNo
Enumeration DateJuly 17, 2022
Last NPPES UpdateJuly 28, 20263 updates tracked since enumeration
NPPES CertifiedJuly 28, 2026
✔ NPI 1780319525 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License✔ Licensed in OH · I.2506260
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.
Also ListedSocial WorkerTaxonomy 104100000X · License S.1700101 (OH)
18123 SLOANE AVE STE 3, Lakewood, OH 44107
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

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Opted out of Medicare

Mallory Tedrick Lisw has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from July 1, 2025 through July 1, 2027.

Opt-Out Effective DateJuly 1, 2025
Opt-Out In Effect ThroughJuly 1, 2027Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 44107 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 $54.34 – $166.65
Typical copayment $0.00 (range $13.58 – $41.66)
Most-billed visit code NA
Established Patient
$68.07 typical visit price
range $17.10 – $135.40
Typical copayment $17.01 (range $4.27 – $33.85)
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 Mallory Tedrick's NPI number?

The NPI number for Mallory Tedrick is 1780319525. It was assigned to this individual provider in the NPPES registry on July 17, 2022.

Where is Mallory Tedrick located?

Mallory Tedrick practices at 18123 Sloane Ave Ste 3, Lakewood, OH 44107. The listed phone number is (440) 782-1117.

What is Mallory Tedrick's specialty?

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

Is Mallory Tedrick enrolled in Medicare?

No. Mallory Tedrick has opted out of Medicare through July 1, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

When was this NPI record last updated?

The NPPES record for Mallory Tedrick was last updated on July 28, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 40 days 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.