Provider Demographics
NPI:1578165536
Name:DRUMMOND, MALLORY JOAN (LPC)
Entity Type:Individual
Prefix:MRS
First Name:MALLORY
Middle Name:JOAN
Last Name:DRUMMOND
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MS
Other - First Name:MALLORY
Other - Middle Name:JOAN
Other - Last Name:MARTIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RBT
Mailing Address - Street 1:2801 C COURT
Mailing Address - Street 2:
Mailing Address - City:ASHTABULA
Mailing Address - State:OH
Mailing Address - Zip Code:44004
Mailing Address - Country:US
Mailing Address - Phone:440-998-4210
Mailing Address - Fax:
Practice Address - Street 1:2801 C COURT
Practice Address - Street 2:
Practice Address - City:ASHTABULA
Practice Address - State:OH
Practice Address - Zip Code:44004
Practice Address - Country:US
Practice Address - Phone:440-998-4210
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-13
Last Update Date:2023-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC2304838101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional