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DR. KATHLEEN M. WALLACE PSY.D
NPI 1770636367
Psychologist - Clinical in Vienna,, OH

Active since January 19, 2007PECOS Enrolled
3400 WARREN-SHARON ROAD, VIENNA,, OH 44473(330) 720-5786 Get Directions Write a Review

NPPES record last updated: September 15, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Dr. Kathleen M. Wallace Psy.d NPPES

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

DR. KATHLEEN M. WALLACE PSY.D (NPI 1770636367) is an individual clinical provider in Vienna,, Ohio, licensed in Pennsylvania (PS015630) and active in the NPI registry since January 2007. She is enrolled in Medicare PECOS, maintains a secondary practice location in New Castle, and is a graduate of Other (1992).

NPPES Registry Identity

NPI1770636367
Entity TypeIndividualFemale
Primary Taxonomy103TC0700X
Provider Legal NameDR. KATHLEEN M. WALLACECredential: PSY.D
Location Address3400 WARREN-SHARON ROADVienna,, OH 44473-9532
Mailing Address3438 Warren Sharon RdVienna, OH 44473-9532 · (330) 720-5786
Phone(330) 720-5786
Sole ProprietorYes
Medical School CMSOtherGraduated 1992
Enumeration DateJanuary 19, 2007
Last NPPES UpdateSeptember 15, 2025
NPPES CertifiedSeptember 15, 2025
✔ NPI 1770636367 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code103TC0700X
Licenses✔ Licensed in PA · PS015630✔ Licensed in OH · 4820
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.
3400 WARREN-SHARON ROAD, Vienna,, OH 44473
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Secondary Practice Location 1

Location 12703 W State StNew Castle, PA 16101-8645 · Phone (724) 657-3303 ext. 101 · Fax (724) 657-3326

Other Identifiers 8

Other7412444Aetna
Other000000867501Anthem Blue Cross Blue Shield
Medicaid0213754OH
Medicaid102574943PA
Other175402Mhnet
Other001947342PA · Highmark Blue Shield
Other1044444Cigna
Other251830792Multiplan Phcs

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Kathleen M. Wallace Psy.d is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID2163666892
PECOS Enrollment IDI20130919000671
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.

Medicare Billing Reassignments

2

Medicare enrollment records show Kathleen Wallace reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Steward Medical Group Inc.
7.4 mi
Internal Medicine
7264 WARREN SHARON RD
Brookfield, OH 44403
  • Reassigned Medicare billing, Pennsylvania enrollment
  • 161 clinicians in this Medicare group
NPI 1902347438 (615) 467-4158
People In Need-Lawrence County
22 mi
Community/Behavioral Health
2703 W STATE ST
New Castle, PA 16101
  • Reassigned Medicare billing, Pennsylvania enrollment
  • 6 clinicians in this Medicare group
NPI 1558341867 (724) 657-3303

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 44473 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$166.65 typical visit price
range $54.34 – $166.65
Typical copayment $41.66 (range $13.58 – $41.66)
Most-billed visit code 99205
Established Patient
$96.44 typical visit price
range $17.10 – $135.40
Typical copayment $24.11 (range $4.27 – $33.85)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES

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

KENNETH RALPH WALLACE II PSY.D.
Psychologist (Clinical)
3400 WARREN-SHARON ROAD
VIENNA, OH 44473
Trumbull County (330) 720-5768

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 Kathleen Wallace's NPI number?

The NPI number for Kathleen Wallace is 1770636367. It was assigned to this individual provider in the NPPES registry on January 19, 2007.

Where is Kathleen Wallace located?

Kathleen Wallace practices at 3400 Warren-Sharon Road, Vienna,, OH 44473. The listed phone number is (330) 720-5786.

What is Kathleen Wallace's specialty?

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

Is Kathleen Wallace enrolled in Medicare?

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

Which organizations bill Medicare for Kathleen Wallace's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kathleen Wallace reassigns Medicare benefits to 2 organizations: Steward Medical Group Inc. (Brookfield, OH) and People In Need-Lawrence County (New Castle, PA). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Kathleen Wallace's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Kathleen Wallace was last updated on September 15, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 months 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.