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Ms. Mallory Ingram, MA,LPC,R-DMT
Mental Health Counselor in Chicago, Illinois
NPI 1275080293

Mallory Ingram is a Mental Health Counselor based in Chicago, IL and is specialized in Mental Health. Mallory Ingram practices in Chicago, IL and has the professional credentials of MA,LPC,R-DMT. The NPI Number for Mallory Ingram is 1275080293 and holds a License No. 178.011231 (Illinois).

The current practice location address for Mallory Ingram is 1100 S May St, Chicago, IL and can be reached out via phone at 312-602-1466 and via fax at 312-733-5211.

Location: 1100 S May St, Chicago, IL, 60614-4045
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Provider Profile Details
NPI Number
1275080293
Provider Name
Mallory Ingram
Credential
MA,LPC,R-DMT
Provider Entity Type
Individual
Gender
Female
Address
1100 S May St, Chicago, IL, 60614-4045
Phone Number
312-602-1466
Fax Number
312-733-5211
Provider Enumeration Date
09/07/2016
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1407971211 05 IL
institution
Provider Business Practice Location Address Details
Address
1100 S May St
City
State
Zip
60607-4229
Phone Number
312-602-1466
Fax Number
312-733-5211
person
Provider Business Mailing Address Details
Address
1100 S May St
City
State
Zip
60607-4229
Phone Number
312-602-1466
Fax Number
312-733-5211
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
License No.
178.011231 (Illinois)
Definition
Definition to come...
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