Individual provider Active NPI

Mallory Christine Welborn, DNP, FNP-BC PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Chattanooga, TN
National Provider Identifier
1841777810
Registry record updated Jun 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
25879 Issued in TN
Practice address
615 McCallie Ave Dept 1801
Chattanooga, TN 37403-2598
Phone
(423) 425-4438
Fax
(423) 425-5527
NPI assigned
Jul 23, 2018
Last updated
Jun 13, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 25879 TN
Psychiatric/Mental Health Nurse Practitioner 363LP0808X GAA-NP000785 GA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 25879 TN Primary

Addresses

Primary practice location

615 McCallie Ave Dept 1801
Chattanooga, TN 37403-2598

Mailing address

615 McCallie Ave Dept 1801
Chattanooga, TN 37403-2598
Phone (423) 425-4438

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.
Opted out of Medicare
Previously, effective Aug 18, 2022 through Aug 18, 2026

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
25879TNMDInternal Medicine Physician
GAA-NP000785GAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Behavioral Health Associates P C PastSince Oct 1, 1997 Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1532304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749772800000",
    "number": "1841777810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 MCCALLIE AVE DEPT 1801",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374032598",
            "telephone_number": "423-425-4438",
            "fax_number": "423-425-5527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 MCCALLIE AVE DEPT 1801",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374032598",
            "telephone_number": "423-425-4438",
            "fax_number": "423-425-5527"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELBORN",
        "first_name": "MALLORY",
        "middle_name": "CHRISTINE",
        "name_prefix": "Dr.",
        "credential": "DNP, FNP-BC PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-23",
        "last_updated": "2025-06-13",
        "certification_date": "2025-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "25879",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "GA",
            "license": "GAA-NP000785",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TN",
            "license": "25879",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chattanooga, TN

Sources for this page

Verify at the official NPI Registry.