GREGORY V MALLIS


Address: 1870 Leonard St Se, Grand Rapids, MI 49505-5650
Phone: 6169561122

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).

Provider Overview

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

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 103T00000X Psychologist 6301015440 MI Behavioral Health & Social Service Providers

Office Location

Street Address 1870 LEONARD ST SE
City GRAND RAPIDS
State MI
Zip Code 49505-5650

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1346637337 Shelby Fullington Social Worker 1011 Ball Ave Ne, Grand Rapids, MI 49505 2015-04-17
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Taxonomy Information

Taxonomy Code 103T00000X
Grouping Behavioral Health & Social Service Providers
Classification Psychologist

Taxonomy Definition

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]

Providers in the same taxonomy and city

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
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City GRAND RAPIDS
Zip Code 49505

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Dataset Information

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.

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