Provider Demographics
NPI:1053199190
Name:HORNING, MALLORY (MSW, MPH, CSW)
Entity type:Individual
Prefix:
First Name:MALLORY
Middle Name:
Last Name:HORNING
Suffix:
Gender:F
Credentials:MSW, MPH, CSW
Other - Prefix:MRS
Other - First Name:MALLORY
Other - Middle Name:
Other - Last Name:WEESE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2451 S TIMBERLINE RD APT 6-104
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80525-4165
Mailing Address - Country:US
Mailing Address - Phone:303-653-5282
Mailing Address - Fax:
Practice Address - Street 1:1220 S COLLEGE AVE STE 200
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80524-3787
Practice Address - Country:US
Practice Address - Phone:720-810-2355
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-19
Last Update Date:2023-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COSWC.0000001555104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker