DR. MAXWELL WALLACE PSYD
NPI 1639676299
Psychologist - Clinical in Rochester, NY

Active since April 10, 2018
600 PARK AVENUE, CARRIAGE HOUSE, ROCHESTER, NY 14607(585) 449-0125 Get Directions Write a Review

NPPES record last updated: July 19, 2018. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jul 19, 2018, Apr 10, 2018 (2 updates tracked since 2018).

About Dr. Maxwell Wallace Psyd NPPES

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

DR. MAXWELL WALLACE PSYD (NPI 1639676299) is an individual clinical provider in Rochester, New York, licensed in New York (022525) and active in the NPI registry since April 2018.

NPPES Registry Identity

NPI1639676299
Entity TypeIndividualMale
Primary Taxonomy103TC0700X
Provider Legal NameDR. MAXWELL WALLACECredential: PSYD
Location Address600 PARK AVENUE, CARRIAGE HOUSERochester, NY 14607
Mailing Address600 Park Avenue, Carriage HouseRochester, NY 14607 · (585) 449-0125
Sole ProprietorYes
Enumeration DateApril 10, 2018
Last NPPES UpdateJuly 19, 20182 updates tracked since enumeration
NPI 1639676299 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 NY · 022525
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.

600 PARK AVENUE, Rochester, NY 14607

Other Identifiers 1

Other6147215NY · Aetna

Other Providers at the Same Location NPPES 2

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

Social Worker (Clinical)
600 PARK AVENUE, CARRIAGE HOUSE
ROCHESTER, NY 14607
Psychologist (Clinical)
600 PARK AVENUE, CARRIAGE HOUSE
ROCHESTER, NY 14607

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 Maxwell Wallace's NPI number?

The NPI number for Maxwell Wallace is 1639676299. It was assigned to this individual provider in the NPPES registry on April 10, 2018.

Where is Maxwell Wallace located?

Maxwell Wallace practices at 600 Park Avenue Carriage House, Rochester, NY 14607. The listed phone number is (585) 449-0125.

What is Maxwell Wallace'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 Maxwell Wallace was last updated on July 19, 2018. NPI Profile syncs with the weekly NPPES data releases published by CMS.