JENNA E WALLACE PSYD
NPI 1619364346
Psychologist in Hurricane, WV

Active since April 21, 2015PECOS Enrolled
3729 TEAYS VALLEY RD, STE 100, HURRICANE, WV 25526(304) 760-6040(304) 760-6042 Get Directions Write a Review

NPPES record last updated: April 8, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Apr 8, 2022, Jul 16, 2021, Jan 11, 2021 and 2 more (5 updates tracked since 2017).

About Jenna E Wallace Psyd NPPES

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

JENNA E WALLACE PSYD (NPI 1619364346) is an individual psychologist in Hurricane, West Virginia and active in the NPI registry since April 2015. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1619364346
Entity TypeIndividualFemale
Primary Taxonomy103T00000X
Provider Legal NameJENNA E WALLACECredential: PSYD
Location Address3729 TEAYS VALLEY RD, STE 100Hurricane, WV 25526-9705
Mailing Address2585 3rd AveHuntington, WV 25703-1642 · (304) 697-1396 · Fax (304) 697-2086
Fax(304) 760-6042
Sole ProprietorYes
Enumeration DateApril 21, 2015
Last NPPES UpdateApril 8, 20225 updates tracked since enumeration
NPPES CertifiedApril 8, 2022
NPI 1619364346 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
Definition
A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.
3729 TEAYS VALLEY RD, Hurricane, WV 25526

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare (PECOS)

Jenna E Wallace Psyd is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 4

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

Family Medicine
3729 TEAYS VALLEY RD, SUITE 100
HURRICANE, WV 25526
Nurse Practitioner (Family)
3729 TEAYS VALLEY RD
HURRICANE, WV 25526
Clinic/Center (Federally Qualified Health Center (FQHC))
3729 TEAYS VALLEY RD, SUITE 100
HURRICANE, WV 25526
Family Medicine
3729 TEAYS VALLEY RD, STE 100
HURRICANE, WV 25526

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 Jenna Wallace's NPI number?

The NPI number for Jenna Wallace is 1619364346. It was assigned to this individual provider in the NPPES registry on April 21, 2015.

Where is Jenna Wallace located?

Jenna Wallace practices at 3729 Teays Valley Rd Ste 100, Hurricane, WV 25526. The listed phone number is (304) 760-6040.

What is Jenna Wallace's specialty?

The primary specialty registered for this NPI is Psychologist with taxonomy code 103T00000X.

Is Jenna Wallace enrolled in Medicare?

Yes. Jenna Wallace is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Jenna Wallace was last updated on April 8, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.