Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Gregory V Mallis, PSYD

Individual provider Psychologist · NPI 1780022194

Gregory V Mallis, PSYD is a Clinical Psychologist in Grand Rapids, Michigan. Qualified in 2012, 14 years ago. Practices with Pine Rest Christian Mental Health Services, a 353-clinician group and accepts Medicare assignment. Licensed in Michigan.

Years since qualifying
14
Licensed in
MI
In the registry since
2013
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

1870 Leonard St SE
Grand Rapids, MI 49505-5650
Phone: (616) 956-1122
Fax: (616) 956-8033
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychologist (primary) Taxonomy 103T00000X · Licence 6301015440 (MI)

Record details

NPI number1780022194
Entity typeIndividual (Type 1)
GenderMale
Credentials PSYD
Sole proprietorNo
NPI enumeratedJune 7, 2013
Last updated in NPPESJune 7, 2013

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL PSYCHOLOGIST
Medical schoolOTHER
Graduated 2012 (14 years in practice)
Group practice Pine Rest Christian Mental Health Services — 353 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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