Colleen Mallory

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

89218 Issued in TX

Practice address

3418 Town and Country Dr
San Angelo, TX 76903

Phone

(325) 653-4673

NPI assigned

Jul 25, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Colleen Babb Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• The Childrens Advocacy Center of Greater West Texas Inc

  • Mental Health Counselor
  • San Angelo, TX
  • NPI 1861081549
  NPD

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

{
    "created_epoch": "1658707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658707200000",
    "number": "1407582307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "705 W 15TH ST",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "76903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3418 TOWN AND COUNTRY DR",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "76903",
            "telephone_number": "325-653-4673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALLORY",
        "first_name": "COLLEEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-25",
        "last_updated": "2022-07-25",
        "certification_date": "2022-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "89218",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "COLLEEN",
            "last_name": "BABB",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Louis James Magana Jr.
• Ashley A Magro, RPH
• Patrick Leroy Mahan, D. C.
• Patrick Clarence Makins, DDS MSD
• Peggy Lee Makowski, C.O.T.A.
• Malone House
• Carl Hubert Malone Jr.
• Stacey L Manion, DO
• Robert Charles Mankin, D.D.S.
• Destiny Renee Manley

• Mental Health Counselor in San Angelo, TX
• Providers in San Angelo, TX by specialty
• Mental Health Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2022; 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.