TRAVIS MAURICE MALLORY
NPI 1720676083
Counselor - Mental Health in Lincoln, NE
Active since January 04, 2021
About Travis Maurice Mallory NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
TRAVIS MAURICE MALLORY (NPI 1720676083) is an individual mental health provider in Lincoln, Nebraska and active in the NPI registry since January 2021.
NPPES Registry Identity
NPI1720676083
Entity TypeIndividualMale
Primary Taxonomy101YM0800X
Provider Legal NameTRAVIS MAURICE MALLORY
Location Address2641 S 70TH ST STE ALincoln, NE 68506-2912
Mailing Address5308 S 65th Street CirLincoln, NE 68516-2382 · (402) 480-5306
Phone(402) 327-9711
Sole ProprietorNo
Enumeration DateJanuary 4, 2021
Last NPPES UpdateAugust 2, 20212 updates tracked since enumeration
NPPES CertifiedApril 22, 2021
✔ NPI 1720676083 is a valid, active identifier and passes the ISO check-digit test.
Specialties & Licenses 2
★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
Also ListedSocial WorkerTaxonomy 104100000X · License CPSS-070 (NE)
2641 S 70TH ST STE A, Lincoln, NE 68506
Other Providers at the Same Location NPPES 7
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Psychologist (Clinical)
2641 S 70TH ST STE A
LINCOLN, NE 68506
LINCOLN, NE 68506
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1720676083, enumerated as an "individual" on January 04, 2021.
The provider is located at 2641 S 70TH ST STE A LINCOLN, NE 68506 and the phone number is (402) 327-9711.
Counselor with taxonomy code 101YM0800X and a focus in Mental Health.
