Provider Demographics
NPI:1346597887
Name:SMOLEN, MALLORIE DANIELLE (LCSW)
Entity Type:Individual
Prefix:
First Name:MALLORIE
Middle Name:DANIELLE
Last Name:SMOLEN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:MALLORIE
Other - Middle Name:
Other - Last Name:CRONKITE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2950 MOUNTAIN LION DR APT 107
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80537-8965
Mailing Address - Country:US
Mailing Address - Phone:970-573-1655
Mailing Address - Fax:855-217-8024
Practice Address - Street 1:1269 CLEVELAND AVE STE 2
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:CO
Practice Address - Zip Code:80537-4724
Practice Address - Country:US
Practice Address - Phone:970-573-1655
Practice Address - Fax:855-217-8024
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-14
Last Update Date:2019-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical