Individual
MS. MALLORY HALLSTEAD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
218 BROADWAY BLVD SE, ALBUQUERQUE, NM 87102-3425
(505) 242-6988
(505) 242-6972
Mailing address
391 WESTERN AVE, ALBANY, NY 12203-1401
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
SWB-2023-0850
NM
1041C0700X
Clinical Social Worker
—
NY
1041C0700X
Clinical Social Worker
—
—
Other
Enumeration date
09/26/2019
Last updated
08/08/2025
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