GREGORY V MALLIS (NPI# 1780022194) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1780022194 |
Entity Type | Individual |
Full Name | GREGORY V MALLIS |
Credential | PSY.D |
Practice Address |
1870 Leonard St Se Grand Rapids MI 49505-5650 |
Mailing Address |
1870 Leonard Street Se Grand Rapids MI 49505-5650 |
Practice Telephone | 6169561122 |
Practice Fax Number | 6169568033 |
Mailing Telephone | 6169561122 |
Mailing Fax Number | 6169568033 |
Enumeration Date | 2013-06-07 |
Last Update Date | 2013-06-07 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 103T00000X | Psychologist | 6301015440 | MI | Behavioral Health & Social Service Providers |
Street Address |
1870 LEONARD ST SE |
City | GRAND RAPIDS |
State | MI |
Zip Code | 49505-5650 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1285276097 | Molly Beth Kerkstra | Home Health Aide | 1115 Ball Ave Nw, Grand Rapids, MI 49505 | 2019-10-14 |
1154849677 | Roshawn Nichol Whitley | Technician | 891 Maryland Ave, Grand Rapids, MI 49505 | 2017-09-05 |
1447778923 | Kelly Benzin-brinks | Social Worker | 1965 3 Mile Rd Ne, Grand Rapids, MI 49505 | 2017-09-05 |
1033560404 | Taylor Nolan Boyd | Speech-Language Pathologist | 400 Ann St Ne Ste 106a, Grand Rapids, MI 49505 | 2016-06-28 |
1023465002 | Calvin Athy | Counselor | 1101 Ballave Ne, Grand Rapids, MI 49505 | 2016-05-19 |
1821456682 | Kelly Van Huisen | Counselor | 1115 Ball Avenue Ne, Building B, Grand Rapids, MI 49505 | 2016-02-08 |
1780051102 | Mark Squeteri | Social Worker | 1345 Monroe Ave Nw Ste 234, Grand Rapids, MI 49505 | 2015-09-02 |
1346637337 | Shelby Fullington | Social Worker | 1011 Ball Ave Ne, Grand Rapids, MI 49505 | 2015-04-17 |
1457745325 | Lester Anderson II | Social Worker | 1115 Ball Ave, Grand Rapids, MI 49505 | 2015-03-27 |
1730570151 | Nicole Brown | Counselor | 1345 Monroe Ave Nw Ste 204, Grand Rapids, MI 49505 | 2015-02-06 |
Find all providers in zip 49505 |
Taxonomy Code | 103T00000X |
Grouping | Behavioral Health & Social Service Providers |
Classification | Psychologist |
A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public. |
Notes: Source: American Psychological Association [1/1/2007: modified definition] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1205490240 | Maxwell Taylor | Psychologist | 401 Hall St Sw Ste 112b, Grand Rapids, MI 49503-4988 | 2019-04-25 |
1760995146 | Stephanie Elizabeth Karek | Psychologist | 4467 Cascade Rd Se Ste A4469, Grand Rapids, MI 49546-3791 | 2017-11-08 |
1114447745 | Andrea Gumbko | Psychologist | 3403 Michigan St Ne, Grand Rapids, MI 49525-3408 | 2017-06-24 |
1720529332 | Clearwater Counseling & Wellness LLC | Psychologist | 1525 E Beltline Se, Grand Rapids, MI 49525-4598 | 2017-03-15 |
1851748768 | Heather Dermyer, LLC | Psychologist | 3330 Centennial Rdg, #205, Grand Rapids, MI 49546-7098 | 2016-05-20 |
1902265234 | Lauren Conkright | Psychologist | 1009 44th St Se, Suite 103, Grand Rapids, MI 49508 | 2016-02-15 |
1225409220 | Christian Robert Komor | Psychologist | 235 Louis St Nw, Grand Rapids, MI 49503-2600 | 2015-10-15 |
1821344136 | Laura Ann Doughty | Psychologist | 800 Monroe Ave Nw Ste 206, Grand Rapids, MI 49503-1448 | 2012-07-24 |
1528321296 | Mikhila N Wildey | Psychologist | 300 58th St Se, Grand Rapids, MI 49548-5984 | 2012-06-19 |
1952699415 | Heart of The City | Psychologist | 540 Cherry St Se, Grand Rapids, MI 49503-4748 | 2011-07-19 |
Find all providers in GRAND RAPIDS |
City | GRAND RAPIDS |
Zip Code | 49505 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.