Individual provider Active NPI

Mallory Suzanne Pavlik, LPC

  • Mental Health Counselor
  • Crystal Lake, IL
National Provider Identifier
1184586844
Registry record updated Dec 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
178.022211 Issued in IL
Practice address
800 S McHenry Ave Ste F
Crystal Lake, IL 60014-7487
Phone
(815) 526-3750
Fax
(815) 526-3440
NPI assigned
Dec 1, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 178.022211 IL Primary

Addresses

Primary practice location

800 S McHenry Ave Ste F
Crystal Lake, IL 60014-7487

Mailing address

26W060 Blackhawk Dr
Wheaton, IL 60189-5904
Phone (630) 818-7223

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
178.022211ILMDMental Health Counselor

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1764547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764547200000",
    "number": "1184586844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26W060 BLACKHAWK DR",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601895904",
            "telephone_number": "630-818-7223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 S MCHENRY AVE STE F",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600147487",
            "telephone_number": "815-526-3750",
            "fax_number": "815-526-3440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAVLIK",
        "first_name": "MALLORY",
        "middle_name": "SUZANNE",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-12-01",
        "last_updated": "2025-12-01",
        "certification_date": "2025-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "178.022211",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crystal Lake, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.