Kaitlyn Lipscomb Wall, M.S, ED.S., NCSP

Primary specialty

School PsychologistTaxonomy code 103TS0200X

License

PPS-0608310 Issued in VA

Practice address

39 Bank St
Chatham, VA 24531-1129

Phone

(434) 432-2761

NPI assigned

Jun 20, 2024

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Pittsylvania County Schools

  • Local Education Agency (LEA)
  • Chatham, VA
  • NPI 1548274848
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1718841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718841600000",
    "number": "1003650581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39 BANK ST",
            "city": "CHATHAM",
            "state": "VA",
            "postal_code": "245311129",
            "telephone_number": "434-432-2761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39 BANK ST",
            "city": "CHATHAM",
            "state": "VA",
            "postal_code": "245311129",
            "telephone_number": "434-432-2761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALL",
        "first_name": "KAITLYN",
        "middle_name": "LIPSCOMB",
        "name_prefix": "Mrs.",
        "credential": "M.S, ED.S., NCSP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-20",
        "last_updated": "2024-06-20",
        "certification_date": "2024-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "VA",
            "license": "PPS-0608310",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tranquility Grove, LLC
• Latasha M Vamper
• Virginia CVS Pharmacy LLC
• Virginia Sport & Spine Institute of Chatham PLLC
• Denise Stickel Walker
• Lee Ann Fulper Waller, PT, DPT
• Weaver Associates, PC
• Christie Altice Weaver, O.D.
• Lauren Y Weaver, FNP
• West Piedmont Healthcare Group, Inc.

• School Psychologist in Chatham, VA
• Providers in Chatham, VA by specialty
• School Psychologist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.