Mallard, Tyron

Mallard, Tyron is an sole proprietor health care provider with primary practice located at 501 N Sunset Ln , Raymore MO 64083-9402. He recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Professional, Behavioral Health & Social Service Providers / Social Worker. Behavioral Health & Social Service Providers / Professional is his primary health care specialty. Mallard, Tyron can be contacted via phone (844) 853-8937.

Contact Information

Primary practice address
501 N Sunset Ln Raymore MO 64083-9402
Phone: (844) 853-8937
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 03303 Kansas
Behavioral Health & Social Service Providers / Professional 101YP2500X CP0227 Nevada
Behavioral Health & Social Service Providers / Social Worker 104100000X 12971 Kansas
Behavioral Health & Social Service Providers / Social Worker 104100000X 10247-M Nevada
Behavioral Health & Social Service Providers / Professional 101YP2500X 2023031673 Missouri

Profile Details

NPI number 1275909889
LBN Legal business name Mallard, Tyron
Credentials MSW, LMHC, CPC, LPC
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 18th, 2015
Last updated Aug 14th, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1275909889 NPPES
Nevada MEDICAID CP0227

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