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

Mallory Tanis

Individual provider Mental Health Counselor · NPI 1457958092

Mallory Tanis is a Mental Health Counselor in Lake Orion, Michigan. Practices as a sole proprietor. Licensed in Michigan.

Licensed in
MI
In the registry since
2020
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Practice location Address checks out

189 W Clarkston Rd
Lake Orion, MI 48362-2892
Phone: (844) 642-9273
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Mental Health Counselor (primary) Taxonomy 101YM0800X · Licence 6401018504 (MI)

Record details

NPI number1457958092
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedOctober 6, 2020
Last updated in NPPESOctober 6, 2020
Certification dateOctober 6, 2020
Mailing addressPo Box 18, Lake Orion, MI 48361-0018

Other providers in Lake Orion