MR. RANDALL DEAN WALLACE M.S.
NPI 1689768707
Psychologist in Cambridge, MN

Active since October 03, 2006
133 2ND AVE SW, CAMBRIDGE, MN 55008(763) 689-9407(763) 552-0164 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Mr. Randall Dean Wallace M.s. NPPES

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

MR. RANDALL DEAN WALLACE M.S. (NPI 1689768707) is an individual psychologist in Cambridge, Minnesota, licensed in Minnesota (LP0683) and active in the NPI registry since October 2006.

NPPES Registry Identity

NPI1689768707
Entity TypeIndividualMale
Primary Taxonomy103T00000X
Provider Legal NameMR. RANDALL DEAN WALLACECredential: M.S.
Location Address133 2ND AVE SWCambridge, MN 55008-1552
Mailing Address199 Coon Rapids Blvd Nw, Suite 306Coon Rapids, MN 55433-5831 · (763) 780-1520 · Fax (763) 780-2114
Fax(763) 552-0164
Sole ProprietorNo
Enumeration DateOctober 3, 2006
Last NPPES UpdateJuly 8, 2007
NPI 1689768707 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
License Licensed in MN · LP0683
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.
133 2ND AVE SW, Cambridge, MN 55008

Accepted Insurance

Other Providers at the Same Location NPPES 6

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

Psychologist (Counseling)
133 2ND AVE SW
CAMBRIDGE, MN 55008
Marriage & Family Therapist
133 2ND AVE SW
CAMBRIDGE, MN 55008
Psychologist
133 2ND AVE SW
CAMBRIDGE, MN 55008
Marriage & Family Therapist
133 2ND AVE SW
CAMBRIDGE, MN 55008
Psychologist
133 2ND AVE SW
CAMBRIDGE, MN 55008
Social Worker
133 2ND AVE SW
CAMBRIDGE, MN 55008

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 Randall Wallace's NPI number?

The NPI number for Randall Wallace is 1689768707. It was assigned to this individual provider in the NPPES registry on October 3, 2006.

Where is Randall Wallace located?

Randall Wallace practices at 133 2nd Ave SW, Cambridge, MN 55008. The listed phone number is (763) 689-9407.

What is Randall Wallace's specialty?

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

What insurance does Randall Wallace accept?

Health plans from HealthPartners and Providence Health Plan list Randall Wallace as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Randall Wallace 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.