Dr Kathleen M Wallace, PSYD is a medicare enrolled "Psychologist - Clinical" provider in Vienna,, Ohio. Her current practice location is
3400 Warren-sharon Road, Vienna,, Ohio. You can reach out to her office (for appointments etc.) via phone at
(330) 720-5786.
Dr Kathleen M Wallace is licensed to practice in Pennsylvania (license number PS015630) and she also participates in the medicare program. She
may accept medicare assignments (which means she may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance) and her NPI Number is 1770636367.
Healthcare Provider's Profile
| Full Name | Dr Kathleen M Wallace |
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| Gender | Female |
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| Speciality | |
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| Experience | Years |
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| Location | 3400 Warren-sharon Road, Vienna,, Ohio |
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| Accepts Medicare Assignments | May be. She may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Dr Kathleen M Wallace attended and graduated from in
NPI Data:
- NPI Number: 1770636367
- Provider Enumeration Date: 01/19/2007
- Last Update Date: 03/26/2015
Medicare PECOS Information:
- PECOS PAC ID:
- Enrollment ID:
Medical Identifiers
Medical identifiers for Dr Kathleen M Wallace such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1770636367 | NPI | - | NPPES |
| 7412444 | Other | | AETNA |
| 000000867501 | Other | | ANTHEM BLUE CROSS BLUE SHIELD |
| 0213754 | Medicaid | OH | |
| 102574943 | Medicaid | PA | |
| 175402 | Other | | MHNET |
| 001947342 | Other | PA | HIGHMARK BLUE SHIELD |
| 1044444 | Other | | CIGNA |
| 251830792 | Other | | MULTIPLAN PHCS |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 103TC0700X | Psychologist - Clinical | 4820 (Ohio) | Secondary |
| 103TC0700X | Psychologist - Clinical | PS015630 (Pennsylvania) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Kathleen M Wallace is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Dr Kathleen M Wallace, PSYD
3438 Warren Sharon Rd,
Vienna, OH 44473-9532
Ph: (330) 720-5786 | Dr Kathleen M Wallace, PSYD
3400 Warren-sharon Road,
Vienna,, OH 44473-9532
Ph: (330) 720-5786 |
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