1. Home
  2. Directory
  3. Ohio
  4. Beachwood
  5. Psychologist
  6. NPI Profile

MARY ELIZABETH WALLER PHD
NPI 1154402113
Psychologist - Clinical in Beachwood, OH

Active since October 18, 2006
3619 PARK EAST DR, SUITE 313, BEACHWOOD, OH 44122(216) 591-0500(216) 591-0550 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Mary Elizabeth Waller Phd NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MARY ELIZABETH WALLER PHD (NPI 1154402113) is an individual clinical provider in Beachwood, Ohio, licensed in Ohio (4312) and active in the NPI registry since October 2006.

NPPES Registry Identity

NPI1154402113
Entity TypeIndividualFemale
Primary Taxonomy103TC0700X
Provider Legal NameMARY ELIZABETH WALLERCredential: PHD
Location Address3619 PARK EAST DR, SUITE 313Beachwood, OH 44122-4330
Mailing Address3619 Park East Dr, Suite 313Beachwood, OH 44122-4330 · (216) 591-0500 · Fax (216) 591-0550
Phone(216) 591-0500
Fax(216) 591-0550
Sole ProprietorNo
Enumeration DateOctober 18, 2006
Last NPPES UpdateJuly 8, 2007
✔ NPI 1154402113 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code103TC0700X
License✔ Licensed in OH · 4312
Definition
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.
3619 PARK EAST DR, Beachwood, OH 44122
Open in Google Maps ↗

Other Identifiers 4

Medicaid0857532OH
Other000000137843OH · Anthem
Medicare ID-Type UnspecifiedCP10029OH
Other6100369OH · Evercare

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

FATUMA MIDAMBA MD INC.
Internal Medicine
3619 PARK EAST DR, 205 S
BEACHWOOD, OH 44122
Cuyahoga County (216) 591-0942
AFFILIATED DIALYSIS OF OHIO LLC
Clinic/Center (End-Stage Renal Disease (ESRD) Treatment)
3619 PARK EAST DR, STE 110-SOUTH
BEACHWOOD, OH 44122
Cuyahoga County (216) 896-0639
DIANA L BATTA LPCC
Counselor
3619 PARK EAST DR, SUITE 313
BEACHWOOD, OH 44122
Cuyahoga County (216) 591-0500
MYTON MEDICAL GROUP, INC.
Internal Medicine
3619 PARK EAST DR, 205 S
BEACHWOOD, OH 44122
Cuyahoga County (216) 591-0942
DR. ALLA SHERMAN M.D.
Pediatrics
3619 PARK EAST DR, SUITE 210
BEACHWOOD, OH 44122
Cuyahoga County (216) 514-8881
SANDRA L STRATMAN APN
Nurse Practitioner (Adult Health)
3619 PARK EAST DR, #318
BEACHWOOD, OH 44122
Cuyahoga County (216) 896-0639
JOHN PFEISTER APRN-CNP
Nurse Practitioner (Occupational Health)
3619 PARK EAST DR
BEACHWOOD, OH 44122
Cuyahoga County (216) 464-6211
JOSEPH M THOMAS MD
Ophthalmology
3619 PARK EAST DR, SUITE 306
BEACHWOOD, OH 44122
Cuyahoga County (216) 292-9150

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mary Waller's NPI number?

The NPI number for Mary Waller is 1154402113. It was assigned to this individual provider in the NPPES registry on October 18, 2006.

Where is Mary Waller located?

Mary Waller practices at 3619 Park East Dr Suite 313, Beachwood, OH 44122. The listed phone number is (216) 591-0500.

What is Mary Waller's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

When was this NPI record last updated?

The NPPES record for Mary Waller was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.