Jill Mallin, PHD, LP
NPI 1184248593ActiveIndividual· Psychologist· Fort Atkinson, WI
Psychologist (PHD, LP) in Fort Atkinson, Wisconsin, licensed in WI, with an NPI issued in June 2020. Enrolled in Medicare as practitioner - clinical psychologist.
Overview
| NPI | 1184248593 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | PHD, LP |
| Sole proprietor | Yes |
| NPI issued | Jun 1, 2020 |
| Last updated in NPPES | Jan 12, 2023 |
| Certified by provider | Jan 12, 2023 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Psychologist Primary | 103T00000X | 2850-57 | WI |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Clinical Psychologist (WI) |
|---|
Education and affiliations
| Graduation year | 2007 |
|---|---|
| Medicare specialty | Clinical Psychologist |
Other Psychologist providers in Fort Atkinson
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- 1720002744