Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Latasha Tene Mallory

Individual provider Clinical Social Worker · NPI 1689566184

Latasha Tene Mallory is a Mental Health Counselor in Chicago, Illinois. Qualified in 1999, 27 years ago. Practices with Vitae Health Medical Illinois, PLLC, a 215-clinician group and accepts Medicare assignment. Licensed in Illinois.

Years since qualifying
27
Licensed in
IL
In the registry since
2025
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Practice location Address checks out

303 E Wacker Dr Ste 1127
Chicago, IL 60601-5215
Phone: (312) 736-1776
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 180005020 (IL)

Record details

NPI number1689566184
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedJuly 18, 2025
Last updated in NPPESJuly 18, 2025
Certification dateJuly 17, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyMENTAL HEALTH COUNSELOR
Medical schoolOTHER
Graduated 1999 (27 years in practice)
Group practice Vitae Health Medical Illinois, Pllc — 215 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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