Deitra Bryant-Mallory, LICSW, LCSW-C
NPI 1063719060 · Clinical Social Worker · Lanham, MD
Enrolled with Medicare as Practitioner - Clinical Social Worker · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Deitra Bryant-Mallory, LICSW, LCSW-C is a Clinical Social Worker provider in Lanham, MD (NPI 1063719060).
Provider details
- NPI number
- 1063719060
- Entity type
- Individual
- Primary specialty
- Clinical Social WorkerBehavioral Health & Social Service Providers
- Credential
- LICSW, LCSW-C
- Sex
- Female
- Sole proprietor
- Yes
- License
- 13673 (MD)
Specialties & taxonomies
Behavioral Health & Social Service Providers
Behavioral Health & Social Service Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
15 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2011-02-28
- Last updated
- 2026-05-22
- Certified
- 2026-05-22
Frequently asked questions
- What is Deitra Bryant-Mallory's NPI number?
- Deitra Bryant-Mallory's National Provider Identifier (NPI) is 1063719060, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Deitra Bryant-Mallory's specialty?
- Deitra Bryant-Mallory is listed in the NPPES registry with a primary specialty of Clinical Social Worker (Behavioral Health & Social Service Providers).
- Where is Deitra Bryant-Mallory located?
- Deitra Bryant-Mallory's practice location on file with NPPES is 10001 Derekwood Ln Ste 120, Lanham, MD 20706-4876.
- What is Deitra Bryant-Mallory's phone number?
- The practice phone number listed in the NPPES registry for Deitra Bryant-Mallory is (301) 306-4590.
- Does Deitra Bryant-Mallory accept Medicare?
- Deitra Bryant-Mallory is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Deitra Bryant-Mallory's NPI active?
- Yes — Deitra Bryant-Mallory's NPI (1063719060) is active in the NPPES registry as of the last update on 2026-05-22.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.