KAREN MARIE WALLIS (NPI# 1730416017) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730416017 |
| Entity Type | Individual |
| Full Name | KAREN MARIE WALLIS |
| Credential | M.ED., PCC, LCDC III |
| Practice Address |
29325 Chagrin Blvd Suite #102 Beachwood OH 44122-4600 |
| Mailing Address |
Po Box 158 Richfield OH 44286-0158 |
| Practice Telephone | 2165480523 |
| Mailing Telephone | 2165480523 |
| Enumeration Date | 2009-11-07 |
| Last Update Date | 2009-11-07 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
091014 | OH | Behavioral Health & Social Service Providers |
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
E. 0500432 | OH | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487253274 | Karen Alaine Wallis | Behavior Technician | 2717 S Glencoe St, Denver, CO 80222-6848 | 2020-10-22 |
| 1215303102 | Karen Lynn Wallis | Occupational Therapist | 135 Meadow Cir, Berea, OH 44017-2610 | 2015-08-14 |
| 1427026053 | Karen Faye Wallis | Chiropractor | 2401 Nowata Pl, Bartlesville, OK 74006-4733 | 2006-03-09 |
| 1174643613 | Karen Ann Wallis | Physical Therapist | 2665 Shefman Ter, Ann Arbor, MI 48105-3441 | 2007-03-29 |
| Street Address |
29325 CHAGRIN BLVD SUITE #102 |
| City | BEACHWOOD |
| State | OH |
| Zip Code | 44122-4600 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780751719 | John W. Angelotta | Counselor | 29325 Chagrin Blvd, Suite 101, Beachwood, OH 44122-4600 | 2006-11-28 |
| 1831592526 | Wendy Marie Kellon | Student in an Organized Health Care Education/Training Program | 29325 Chagrin Blvd, Suite 313, Beachwood, OH 44122-4600 | 2014-10-08 |
| 1427190792 | Susan G Berman | Social Worker | 29325 Chagrin Blvd, Suite 102, Beachwood, OH 44122-4600 | 2007-02-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760083174 | Sophia Denise Moncrieffe-jordan | Nurse Practitioner | 23511 Chargin Blvd, Apt. E312, Beachwood, OH 44122 | 2020-11-03 |
| 1447864400 | Resilient Bodies LLC | Massage Therapist | 24300 Chagrin Blvd #312, Beachwood, OH 44122 | 2020-09-06 |
| 1215576087 | Hni Emergency Services of Ohio, LLC | Nurse Practitioner | 22501 Chagrin Blvd, Beachwood, OH 44122 | 2019-12-27 |
| 1013555648 | Barbara L Ekelman Phd Inc | Psychologist | 24100 Chagrin Blvd, Suite 385, Beachwood, OH 44122 | 2019-12-13 |
| 1417599770 | Janise Moore | Technician | 19600 Gladstone Rd, Warrensville Hts, OH 44122 | 2019-10-08 |
| 1598312704 | Nizar Andria | Student in an Organized Health Care Education/Training Program | Cedar Rd 27050, Apartment 515, Beachwood, OH 44122 | 2019-08-22 |
| 1437703998 | Malinda Ann Davis | Social Worker | 20600 Chagrin Blvd Suite 320, Shaker Heights, OH 44122 | 2019-08-01 |
| 1891265864 | Karlan Champagne | Case Management | 23215 Commerence Park, 306, Beachwood, OH 44122 | 2018-12-03 |
| 1952896565 | Donna Pinkney | Counselor | 20550 University Blvd Apt 206, Shaker Hts, OH 44122 | 2018-06-26 |
| 1255825857 | Elizabeth Anne Donathan | Registered Nurse | 4100 Warrensville Center Rd Ste 101, Warrensville Heights, OH 44122 | 2018-06-18 |
| Find all providers in zip 44122 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346897246 | Colleen Monn | Counselor | 21403 Chagrin Blvd Ste 195, Beachwood, OH 44122-5322 | 2019-08-25 |
| 1326602582 | Amy L. Gould, LLC | Counselor | 3659 S Green Road, Suite 101, Beachwood, OH 44122-5715 | 2019-04-23 |
| 1326552837 | Allison West Kaskey | Counselor | 24300 Chagrin Blvd Ste 209, Beachwood, OH 44122-5629 | 2017-11-20 |
| 1063951341 | Partners To Empowerment Wellness Center | Counselor | 3681 Green Rd Ste 406, Beachwood, OH 44122-5716 | 2017-02-20 |
| 1972059301 | Kristina Metcalf | Counselor | 23240 Chagrin Blvd Ste 500, Beachwood, OH 44122 | 2016-08-26 |
| 1790122422 | Elizabeth A Goodwin | Counselor | 3659 S. Green Rd, 100, Beachwood, OH 44122 | 2013-06-04 |
| 1861836223 | Neil Jack Lavender | Counselor | 1026 Seaman Ave, Beachwood, NJ 08722-3406 | 2013-04-28 |
| 1972859353 | Christina Renee Hall | Counselor | 3355 Richmond Rd Ste 225, Beachwood, OH 44122-4180 | 2012-08-03 |
| 1477747996 | Frederick Joseph Baddour | Counselor | 3401 Enterprise Parkway, Suite 340, Beachwood, OH 44133-7340 | 2007-08-28 |
| 1003037623 | Melissa Nicole Daniele | Counselor | 23240 Chagrin Boulevard Suite 270, Beachwood, OH 44122 | 2007-05-01 |
| Find all providers in BEACHWOOD | ||||
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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.