Mallory Sisson
Individual provider Active NPI Mental Health Counselor · Dixon, IL
NPI 1790455673 · NPPES record last updated Sep 14, 2021
Key facts
- NPI
- 1790455673
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- Practice address
- 325 Il Route 2
Dixon, IL 61021-9118 - Phone
- (815) 284-6611
- NPI assigned
- Sep 14, 2021
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Yes |
Addresses
Primary practice location
325 Il Route 2
Dixon, IL 61021-9118
Mailing address
325 Il Route 2
Dixon, IL 61021-9118
Other providers in Dixon, IL
- Sinnissippi Centers, Inc.
- Sinnissippi Centers, Inc.
- Sinnissippi Centers, Inc.
- Sinnissippi Centers, Inc.
- Sinnissippi Centers, Inc.
- Lydia Christina Sitter
- Connor Skoumal
- Bryn Slager
- Hope Smeltzer
- Cassandra Smiley
All providers in Dixon, IL · Mental Health Counselor in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 14, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.