Active NPI
Lou Ann Carey Wallace, SR. PSYC. EXAMINER
- Clinical Psychologist
- Parsons, TN
National Provider Identifier
1063742922
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PE0000001013
- Practice address
- 35 Jeannie Belle Yarboro Rd
Parsons, TN 38363-3305 - Phone
- (731) 549-4382
- NPI assigned
- Dec 28, 2009
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PE0000001013 | TN | Primary |
Addresses
Primary practice location
35 Jeannie Belle Yarboro Rd
Parsons, TN 38363-3305
Mailing address
PO Box 205
Parsons, TN 38363-0205
Phone (731) 549-4382
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PE0000001013 | TN | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1261958400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1261958400000",
"number": "1063742922",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 205",
"city": "PARSONS",
"state": "TN",
"postal_code": "383630205",
"telephone_number": "731-549-4382"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "35 JEANNIE BELLE YARBORO RD",
"city": "PARSONS",
"state": "TN",
"postal_code": "383633305",
"telephone_number": "731-549-4382"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALLACE",
"first_name": "LOU ANN",
"middle_name": "CAREY",
"credential": "SR. PSYC. EXAMINER",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-12-28",
"last_updated": "2009-12-28",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "TN",
"license": "PE0000001013",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Parsons, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.