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Deactivated NPI 1114090263 Deactivated / Inactive NPI Male Practitioner

Dr. William J. Mallot , PsyD

Psychologist - Clinical • Springfield, MO

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. William Mallot has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date November 16, 2006
NPI Deactivation Date October 16, 2024
Total Practice Duration ~18 Years of Practice (2006 – 2024)

Professional Overview & Biography Verified Profile Summary

Dr. William Mallot, PsyD was a registered Psychologist - Clinical practicing in Springfield, MO. Throughout an active medical career spanning 18 years, Dr. Mallot provided care at the practice location at 1300 E BRADFORD PKWY until profile deactivation on 2024-10-16.

Historical Medicare Part B clinical services included psychotherapy, psychiatric diagnostic evaluation. Public procedure reimbursement records and service volume details are provided below for historical transparency.

Practice Location & Contact Primary Location

Practice Address

1300 E Bradford Pkwy

Springfield, MO 658044264

Telephone 4177615000
Fax 4177615011
Associated Practice Facility / Clinic
🏢 Burrell, Inc. Facility NPI 1881659894

Specialty Benchmarks & Practice Insights

Comparative analytics for Psychologist - Clinical in Springfield, MO

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 20.8 Yrs
State Avg: 20.2 Yrs
Regional Practice Density
154 Specialists

Practicing in Springfield, MO (963 Statewide)

Telehealth Adoption Rate
9.1% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
21.9% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2022)
Reporting Year:
HCPCS Code & Description Services Patients Submitted Charge Medicare Allowed
90834 Psychotherapy, 45 minutes
130 15 $138.77 $100.58
90791 Psychiatric diagnostic evaluation
14 14 $200.00 $163.88

Medical Specialties & State Licenses

Psychologist - Clinical Primary Specialty

NUCC Taxonomy Code: 103TC0700X

State License MO 2006036652

A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners
Dr. Jayaprabha Lafontaine , MD

Psychiatry & Neurology - Psychiatry

NPI 1003257833

Doctor of Medicine (M.D.)

Allison Robertson , MSW, LCSW

Social Worker - Clinical

NPI 1003505579

Master of Social Work, Licensed Clinical Social Worker

Jessica Aldrich , LMSW

Social Worker - Clinical

NPI 1003636150

Licensed Master Social Worker

Dr. Charles Thomas , MD

Psychiatry & Neurology - Psychiatry

NPI 1003812074

Doctor of Medicine (M.D.)

Deirdra Harris , MS, LPC

Counselor - Professional

NPI 1013207158

Master of Science, Licensed Professional Counselor

Michael Cotter , MS, LPC

Counselor - Professional

NPI 1013427657

Master of Science, Licensed Professional Counselor

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

11 Historical Events
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NPI Profile Deactivated October 16, 2024

Record deactivated on October 16, 2024

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Updated Practice Location July 13, 2023

Registered at 140 WELDON PKWY, MARYLAND HEIGHTS, MO 630433102 (Tel: 3149485573)

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Updated Business Mailing Address July 13, 2023

Registered at 140 WELDON PKWY, MARYLAND HEIGHTS, MO 630433102 (Tel: 3149485576)

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Provider Name / Credentials Updated July 13, 2023

Recorded as WILLIAM MALLOT, LPC

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 13, 2023

Counselor (License #2003014203 in MO)

NPI Profile Active August 09, 2013

NPI status registered as active in NPPES database

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Updated Practice Location August 09, 2013

Registered at 1300 E BRADFORD PKWY, SPRINGFIELD, MO 658044264 (Tel: 4177615000)

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Updated Business Mailing Address August 09, 2013

Registered at 1300 E BRADFORD PKWY, SPRINGFIELD, MO 658044264 (Tel: 4177615000)

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Provider Name / Credentials Updated August 09, 2013

Recorded as WILLIAM MALLOT, PSYD

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Medical Taxonomy / Specialty Registered (Primary Specialty) August 09, 2013

Psychologist (License #2006036652 in MO)

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Initial NPI Registration & Enumeration November 16, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1114090263
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: November 16, 2006
Last Update: August 09, 2013
Deactivation Date: October 16, 2024

Mailing Address

1300 E Bradford Pkwy

Springfield, MO 658044264

Phone: 4177615000

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.