DR. KALLEY MARIE WALLER PSYD
NPI 1861165060
Psychologist in Provo, UT

Active since July 26, 2021PECOS Enrolled
750 N FREEDOM BLVD STE 300, PROVO, UT 84601(801) 373-4760(801) 373-0639 Get Directions Write a Review

NPPES record last updated: November 26, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jul 22, 2024, Jul 20, 2024, May 22, 2023 and 2 more (5 updates tracked since 2021).

About Dr. Kalley Marie Waller Psyd NPPES

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

DR. KALLEY MARIE WALLER PSYD (NPI 1861165060) is an individual psychologist in Provo, Utah, licensed in Utah (14193440-2501) and active in the NPI registry since July 2021. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1861165060
Entity TypeIndividualFemale
Primary Taxonomy103T00000X
Provider Legal NameDR. KALLEY MARIE WALLERCredential: PSYD
Location Address750 N FREEDOM BLVD STE 300Provo, UT 84601-1690
Mailing Address750 N Freedom BlvdProvo, UT 84601-1677 · (801) 373-4760 · Fax (801) 373-0639
Fax(801) 373-0639
Sole ProprietorNo
Enumeration DateJuly 26, 2021
Last NPPES UpdateNovember 26, 20245 updates tracked since enumeration
NPPES CertifiedNovember 26, 2024
NPI 1861165060 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 UT · 14193440-2501
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.

750 N FREEDOM BLVD STE 300, Provo, UT 84601

Accepted Insurance

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

Enrolled in Medicare (PECOS)

Dr. Kalley Marie Waller 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 20

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

Marriage & Family Therapist
750 N FREEDOM BLVD STE 300
PROVO, UT 84601
Social Worker
750 N FREEDOM BLVD STE 300
PROVO, UT 84601
Community Health Worker
750 N FREEDOM BLVD STE 300
PROVO, UT 84601
Case Manager/Care Coordinator
750 N FREEDOM BLVD STE 300
PROVO, UT 84601
Case Manager/Care Coordinator
750 N FREEDOM BLVD STE 300
PROVO, UT 84601
Student in an Organized Health Care Education/Training Program
750 N FREEDOM BLVD STE 300
PROVO, UT 84601
Case Manager/Care Coordinator
750 N FREEDOM BLVD STE 300
PROVO, UT 84601
Social Worker (Clinical)
750 N FREEDOM BLVD STE 300
PROVO, UT 84601

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 Kalley Waller's NPI number?

The NPI number for Kalley Waller is 1861165060. It was assigned to this individual provider in the NPPES registry on July 26, 2021.

Where is Kalley Waller located?

Kalley Waller practices at 750 N Freedom Blvd Ste 300, Provo, UT 84601. The listed phone number is (801) 373-4760.

What is Kalley Waller's specialty?

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

Is Kalley Waller enrolled in Medicare?

Yes. Kalley Waller is registered in the Medicare PECOS enrollment system.

What insurance does Kalley Waller accept?

Health plans from BridgeSpan Health Company, Regence BlueCross BlueShield of Utah and Select Health list Kalley Waller 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 Kalley Waller was last updated on November 26, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.