ROGER A WALLACE (NPI# 1053501783) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053501783 |
| Entity Type | Individual |
| Full Name | ROGER A WALLACE |
| Credential | MA |
| Practice Address |
410 Mills Gap Rd. Arden NC 28704 |
| Mailing Address |
Po Box 127 Arden NC 28704-0127 |
| Practice Telephone | 8286540111 |
| Practice Fax Number | 8286540111 |
| Mailing Telephone | 8286540111 |
| Mailing Fax Number | 8286540111 |
| Enumeration Date | 2007-07-30 |
| Last Update Date | 2008-10-16 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103T00000X | Psychologist | 1179 | NC | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 6107178 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083645501 | Roger Charles Wallace | Emergency Medicine | 23845 Mcbean Pkwy, Valencia, CA 91355-2001 | 2006-07-05 |
| 1609838481 | Roger Lewis Wallace | Obstetrics & Gynecology | 2900 12th Ave N, Suite 130w, Billings, MT 59101-7506 | 2006-04-05 |
| Street Address |
410 MILLS GAP RD. |
| City | ARDEN |
| State | NC |
| Zip Code | 28704 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801410949 | Lindsey Marie Gates | Dentist | 226 New Airport Rd Ste 30, Arden, NC 28704 | 2020-06-04 |
| 1669025565 | Casey Cho Dds Pllc | Dentist | 150 Airport Rd. Suite 30, Arden, NC 28704 | 2019-07-19 |
| 1700370913 | Eric Seth Shapiro | Chiropractor | 32 Southwicke Dr, Arden, NC 28704 | 2018-06-20 |
| 1285180406 | Adam Herbst | Physical Therapy Assistant | 101 Roberts Lake Circle Apt 105, Arden, NC 28704 | 2016-08-28 |
| 1760820013 | Dove Shoneman | Acupuncturist | 600 Julian Lane, Suite 660, Arden, NC 28704 | 2013-06-10 |
| 1710288378 | Higher Ground Pediatric Therapy, Pllc | Community/Behavioral Health | 3749 Sweeten Creek Road Suites 1-2, Arden, NC 28704 | 2010-11-12 |
| 1962642868 | Pandora M Hodge | Physician Assistant | 436 Airport Road, Suite 20, Arden, NC 28704 | 2009-03-05 |
| 1710135009 | Wal-mart Stores, Inc. | Eyewear Supplier (Equipment, not the service) | 60 Airport Rd., Asheville, NC 28704 | 2008-08-29 |
| 1679732598 | Patty Ann Dalton | Social Worker | 126 Locust Court, Arden, NC 28704 | 2008-06-05 |
| 1285835314 | Diane Swift Feinberg | Counselor | 15 Spring Hill Dr, Arden, NC 28704 | 2007-05-29 |
| Find all providers in zip 28704 | ||||
| Taxonomy Code | 103T00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| 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. |
| Notes: Source: American Psychological Association [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376803304 | Anthony G. Hazelton | Psychologist | 15 Skyland Inn Dr, Arden, NC 28704-7714 | 2012-05-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194338749 | Akaosa Onuma Eleanya | Psychologist | 4413 Wedgewood Dr, Raleigh, NC 27604-5098 | 2020-08-24 |
| 1720698939 | Blue Ridge Behavior Systems Inc | Psychologist | 16147 Lancaster Hwy Ste 110, Charlotte, NC 28277-4196 | 2020-08-03 |
| 1538778584 | Stephanie Goodson | Psychologist | 1638 Lookout Cir, Waxhaw, NC 28173-8085 | 2020-07-27 |
| 1205453388 | Gregory A Welikson, Phd, Pllc | Psychologist | 1334 Daventry Ct, Chapel Hill, NC 27517-9412 | 2020-07-06 |
| 1689297921 | David B Spano | Psychologist | 3205 N Mcdowell St, Charlotte, NC 28205-1552 | 2020-05-21 |
| 1174145338 | Matthew Charles Whited | Psychologist | Pass Clinic Rawl Building Room 311, East Carolina University, Greenville, NC 27858 | 2020-05-11 |
| 1952939811 | A4psychology, Pllc | Psychologist | 596 Executive Pl Ste 201, Fayetteville, NC 28305-5189 | 2020-03-27 |
| 1407487226 | James Francis Skane Jr. | Psychologist | 123 S 29th St, Wilmington, NC 28403-1223 | 2020-01-30 |
| 1932746294 | Lindsay Pulver | Psychologist | 3501 Sherbourne Ln, Greensboro, NC 27405-4964 | 2019-12-05 |
| 1164065827 | Whitney Beth Griffin | Psychologist | 2310 Stinson Drive Ncsu Dept of Psychology 640 Poe Hall, Raleigh, NC 27695-0001 | 2019-10-24 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.