KAREN MARIE WALLIS M.ED., PCC, LCDC III
NPI 1730416017
Counselor - Mental Health in Beachwood, OH
About Karen Marie Wallis M.ed., Pcc, Lcdc Iii NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
KAREN MARIE WALLIS M.ED., PCC, LCDC III (NPI 1730416017) is an individual mental health provider in Beachwood, Ohio, licensed in Ohio (E. 0500432) and active in the NPI registry since November 2009. She has opted out of Medicare through January 17, 2028.
NPPES Registry Identity
Specialties & Licenses 2
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Opted out of Medicare
Karen Marie Wallis M.ed., Pcc, Lcdc Iii has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from January 17, 2024 through January 17, 2028.
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.
CLEVELAND, OH 44122
BEACHWOOD, OH 44122
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 Karen Wallis's NPI number?
The NPI number for Karen Wallis is 1730416017. It was assigned to this individual provider in the NPPES registry on November 7, 2009.
Where is Karen Wallis located?
Karen Wallis practices at 29325 Chagrin Blvd Suite #102, Beachwood, OH 44122. The listed phone number is (216) 548-0523.
What is Karen Wallis's specialty?
The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.
Is Karen Wallis enrolled in Medicare?
No. Karen Wallis has opted out of Medicare through January 17, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.
When was this NPI record last updated?
The NPPES record for Karen Wallis was last updated on November 7, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.
# Karen Marie Wallis, M.ED., PCC, LCDC III · NPI 1730416017
Mental Health provider in Beachwood, Ohio. Individual provider, active in the CMS NPPES registry since November 7, 2009.
## Identity
- **NPI:** 1730416017 (Entity type: Individual)
- **Enumerated:** November 7, 2009
- **Primary specialty:** Counselor - Mental Health · taxonomy 101YM0800X
- **State license:** E. 0500432 (Ohio)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 29325 CHAGRIN BLVD, SUITE #102, Beachwood, OH 44122-4600
- **Phone:** (216) 548-0523
## Medicare
- **Medicare:** Opted out of Medicare (opt-out affidavit on file, in effect through January 17, 2028); services are provided under private contract
## Record status
- **NPPES last updated:** November 7, 2009
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Source: [NPI Profile](https://npiprofile.com/npi/1730416017) · Data from the CMS NPPES public registry.