Individual provider · Type 1 NPI
Mallory Marra
Mental Health Counselor · Charleston, SC
NPI number
1174345854
Active
Practice location
18 Sothel Ave
Charleston, SC 29407-7320
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Mental Health Counselor Primary | 101YM0800X | LC15341 (MD) |
| Professional Counselor | 101YP2500X | PC019497 (PA) |
| Professional Counselor | 101YP2500X | 9722 (SC) |
| Mental Health Counselor | 101YM0800X | PRC200012642 (DC) |
Mental Health Counselor: Definition to come...
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About NPI 1174345854
Mallory Marra's National Provider Identifier is 1174345854, issued on Oct 24, 2024. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Charleston, SC. The record was last updated on Jul 10, 2026.