Provider Demographics
NPI:1134693419
Name:GETTO, MALLORIE LEIGH (LCSW)
Entity Type:Individual
Prefix:
First Name:MALLORIE
Middle Name:LEIGH
Last Name:GETTO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13103 CAMERON DR
Mailing Address - Street 2:
Mailing Address - City:DONNELLY
Mailing Address - State:ID
Mailing Address - Zip Code:83615-5054
Mailing Address - Country:US
Mailing Address - Phone:775-217-2208
Mailing Address - Fax:
Practice Address - Street 1:211 FOREST ST
Practice Address - Street 2:
Practice Address - City:MCCALL
Practice Address - State:ID
Practice Address - Zip Code:83638-5256
Practice Address - Country:US
Practice Address - Phone:208-634-2225
Practice Address - Fax:208-634-7212
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-19
Last Update Date:2023-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLCSW-405221041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical