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

Mr. Scott Robert Mallon

Individual provider Marriage & Family Therapist · NPI 1700164803

Mr. Scott Robert Mallon is a Marriage and Family Therapist in Staten Island, New York. Qualified in 2009, 17 years ago. Licensed in New York.

Years since qualifying
17
Licensed in
NY
In the registry since
2011
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Practice location Address checks out

1688 Victory Blvd
Staten Island, NY 10314-3547
Phone: (718) 815-4111
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Marriage & Family Therapist (primary) Taxonomy 106H00000X · Licence 000874-1 (NY)

Record details

NPI number1700164803
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedJuly 25, 2011
Last updated in NPPESJuly 25, 2011

Medicare enrollment

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

Medicare specialtyMARRIAGE AND FAMILY THERAPIST
Medical schoolOTHER
Graduated 2009 (17 years in practice)
Accepts Medicare assignment Not indicated

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