DR. JILL MALLIN PHD, LP
NPI 1184248593
Psychologist in Fort Atkinson, WI

Active since June 01, 2020PECOS Enrolled
201 N MAIN ST STE 411, FORT ATKINSON, WI 53538(920) 397-4015(608) 237-2146 Get Directions Write a Review

NPPES record last updated: January 12, 2023. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jan 12, 2023, Jun 1, 2020 (2 updates tracked since 2020).

About Dr. Jill Mallin Phd, Lp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. JILL MALLIN PHD, LP (NPI 1184248593) is an individual psychologist in Fort Atkinson, Wisconsin, licensed in Wisconsin (2850-57) and active in the NPI registry since June 2020. She is enrolled in Medicare PECOS and is a graduate of Other (2007).

NPPES Registry Identity

NPI1184248593
Entity TypeIndividualFemale
Primary Taxonomy103T00000X
Provider Legal NameDR. JILL MALLINCredential: PHD, LP
Location Address201 N MAIN ST STE 411Fort Atkinson, WI 53538-1805
Mailing Address201 N Main St Ste 411Fort Atkinson, WI 53538-1805 · (920) 397-4015 · Fax (608) 237-2146
Fax(608) 237-2146
Sole ProprietorYes
Medical School CMSOtherGraduated 2007
Enumeration DateJune 1, 2020
Last NPPES UpdateJanuary 12, 20232 updates tracked since enumeration
NPPES CertifiedJanuary 12, 2023
✔ NPI 1184248593 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
License✔ Licensed in WI · 2850-57
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.
201 N MAIN ST STE 411, Fort Atkinson, WI 53538

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Jill Mallin Phd, Lp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID840603247
PECOS Enrollment IDI20210104000537
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Jill Mallin reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Community/Behavioral Health
10 S WATER ST E
Fort Atkinson, WI 53538
  • Reassigned Medicare billing, Wisconsin enrollment

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jill Mallin's NPI number?

The NPI number for Jill Mallin is 1184248593. It was assigned to this individual provider in the NPPES registry on June 1, 2020.

Where is Jill Mallin located?

Jill Mallin practices at 201 N Main St Ste 411, Fort Atkinson, WI 53538. The listed phone number is (920) 397-4015.

What is Jill Mallin's specialty?

The primary specialty registered for this NPI is Psychologist with taxonomy code 103T00000X.

Is Jill Mallin enrolled in Medicare?

Yes. Jill Mallin is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Jill Mallin's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jill Mallin reassigns Medicare benefits to Hidden Path Counseling, LLC (Fort Atkinson, WI). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Jill Mallin's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Jill Mallin accept?

Health plans from Dean Health Plan, Group Health Cooperative-SCW, Quartz and UnitedHealthcare list Jill Mallin as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Jill Mallin was last updated on January 12, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.