JORDAN MALLERY NPI 1891575254

NPI Information

NPI: 1891575254
Provider Name: JORDAN MALLERY
Classification: Counselor - 101Y00000X
Entity Type: Individual
Address:
1190 E WASHINGTON ST
GRAYSLAKE, IL
ZIP 60030
Phone: (847) 549-2235
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Jordan Mallery is a counselor in Grayslake, IL. The provider is a provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification. Jordan Mallery NPI is 1891575254. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1190 E WASHINGTON ST
GRAYSLAKE, IL
ZIP 60030-960
Phone: (847) 549-2235

The enumeration date for this NPI number is 10/3/2023 and was last updated on 10/3/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101Y00000X	Counselor				Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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