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MALLORY POLIVKA M.A., R-DMT
NPI 1821514563
Student in an Organized Health Care Education/Training Program in Duluth, MN

Active since August 15, 2017
101 W 2ND ST, DULUTH, MN 55802(218) 724-3122 Get Directions Write a Review

NPPES record last updated: August 20, 2018. Verified against the NPPES registry weekly; last sync: August 30, 2026.

Record update history: Aug 20, 2018, Aug 15, 2017 (2 updates tracked since 2017).

About Mallory Polivka M.a., R-dmt NPPES

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

MALLORY POLIVKA M.A., R-DMT (NPI 1821514563) is an individual student in an organized health care education/training program in Duluth, Minnesota and active in the NPI registry since August 2017.

NPPES Registry Identity

NPI1821514563
Entity TypeIndividualFemale
Primary Taxonomy390200000X
Provider Legal NameMALLORY POLIVKACredential: M.A., R-DMT
Location Address101 W 2ND STDuluth, MN 55802
Mailing Address211 Morley PkwyDuluth, MN 55803-2127
Phone(218) 724-3122
Sole ProprietorNo
Enumeration DateAugust 15, 2017
Last NPPES UpdateAugust 20, 20182 updates tracked since enumeration
✔ NPI 1821514563 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
101 W 2ND ST, Duluth, MN 55802
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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ADAM WENZEL
Behavior Technician
101 W 2ND ST
DULUTH, MN 55802
St. Louis County (218) 724-3122
JILL C BLOOMER RN
Nurse Practitioner (Psychiatric/Mental Health)
101 W 2ND ST
DULUTH, MN 55802
St. Louis County (907) 854-6005
MISS CARRIE ANN BABICH LPCC
Counselor (Professional)
101 W 2ND ST
DULUTH, MN 55802
St. Louis County (218) 216-3963
ALISA HITCHINGS MSC
Counselor (Mental Health)
101 W 2ND ST
DULUTH, MN 55802
St. Louis County (218) 387-5214
TOMINA LEIGH SLEVIN BS
Counselor (Mental Health)
101 W 2ND ST
DULUTH, MN 55802
St. Louis County (218) 722-3122
JACOB ERIC NUSTAD-PELUSO
Counselor (Mental Health)
101 W 2ND ST
DULUTH, MN 55802
St. Louis County (218) 724-3122
ANNA CECILIA KATELYN CARLSON
Counselor (Mental Health)
101 W 2ND ST
DULUTH, MN 55802
St. Louis County (218) 724-3122
STACEY KAY FLOM
Counselor (Mental Health)
101 W 2ND ST
DULUTH, MN 55802
St. Louis County (218) 724-3122

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 Mallory Polivka's NPI number?

The NPI number for Mallory Polivka is 1821514563. It was assigned to this individual provider in the NPPES registry on August 15, 2017.

Where is Mallory Polivka located?

Mallory Polivka practices at 101 W 2nd St, Duluth, MN 55802. The listed phone number is (218) 724-3122.

What is Mallory Polivka's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

When was this NPI record last updated?

The NPPES record for Mallory Polivka was last updated on August 20, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.