Dr Kathleen M Wallace, PSYD is a medicare enrolled "Psychologist - Clinical" provider in Vienna,, Ohio. She graduated from medical school in 1992 and has 33 years of diverse experience with area of expertise as Clinical Psychologist. She is a member of the group practice People In Need-lawrence County and 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 | Clinical Psychologist |
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Experience | 33 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. |
Medical Education and Training:
- Dr Kathleen M Wallace graduated from medical school in 1992
NPI Data:
- NPI Number: 1770636367
- Provider Enumeration Date: 01/19/2007
- Last Update Date: 03/26/2015
Medicare PECOS Information:
- PECOS PAC ID: 2163666892
- Enrollment ID: I20130919000671
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 |
Group Practice Association
Group Practice Name | Group PECOS PAC ID | No. of Members |
People In Need-lawrence County | 6305833963 | 5 |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Kathleen M Wallace allows following entities to bill medicare on her behalf.
Entity Name | People In Need-lawrence County |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1558341867 PECOS PAC ID: 6305833963 Enrollment ID: O20040427000910 |
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Entity Name | Steward Medical Group Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1902347438 PECOS PAC ID: 2860688728 Enrollment ID: O20170524000169 |
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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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