Healthcare Provider Details

I. General information

NPI: 1831565829
Provider Name (Legal Business Name): MALLORY BISHER ARNP, PMHNP-BC, LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MALLORY ANDREASSEN M.A., LMHC

II. Dates (important events)

Enumeration Date: 08/13/2015
Last Update Date: 02/13/2026
Certification Date: 02/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10888 HICKMAN RD STE 3A
CLIVE IA
50325-3715
US

IV. Provider business mailing address

10888 HICKMAN RD STE 3A
CLIVE IA
50325-3715
US

V. Phone/Fax

Practice location:
  • Phone: 515-639-0034
  • Fax: 515-738-3369
Mailing address:
  • Phone: 515-639-0034
  • Fax: 515-738-3369

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberG181636
License Number StateIA
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number092680
License Number StateIA
# 3
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberCC01021
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: