Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dr. Ivy J Mallisham, PSYD

Individual provider Clinical Psychologist · NPI 1689653743

Dr. Ivy J Mallisham, PSYD is a Clinical Psychologist in Columbus, Georgia. Practices as a sole proprietor. Licensed in Georgia.

Licensed in
GA
In the registry since
2006
What do these letters mean?
PSYD — Doctor of Psychology
A doctoral psychologist trained primarily for clinical practice.

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Practice location Address checks out

5041 Warm Springs Rd Ste B
Columbus, GA 31909-6938
Phone: (706) 569-9199
Fax: (706) 569-8990
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Psychologist (primary) Taxonomy 103TC0700X · Licence PSY001132 (GA)

Record details

NPI number1689653743
Entity typeIndividual (Type 1)
GenderFemale
Credentials PSYD
Sole proprietorYes
NPI enumeratedJanuary 16, 2006
Last updated in NPPESJuly 9, 2007

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