NPIMap

Organization Active NPI

Total Care Psychological & Counseling Services Inc

  • Clinical Psychologist
  • Youngstown, OH
National Provider Identifier
1235354473
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
4312 Issued in OH
Legal business name
TOTAL CARE PSYCHOLOGICAL & COUNSELING SERVICES INC
Practice address
5500 Market St
Suite 90
Youngstown, OH 44512-2601
Phone
(330) 782-7701
Fax
(330) 782-8785
NPI assigned
Apr 14, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Mary Newell Waller, PHD
Title
Psychologist
Phone
(330) 782-7701

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X 4312 OH Primary

Addresses

Primary practice location

5500 Market St
Suite 90
Youngstown, OH 44512-2601

Mailing address

5500 Market St
Suite 90
Youngstown, OH 44512-2601
Phone (330) 782-7701

Other identifiers 6

IdentifierTypeStateIssuer
7972009OtherOHAETNA
96550OtherOHCIGNA
306089OtherOHMHN
166850OtherOHANTHEM
0027898OtherOHTRI CARE
1445316OtherOHHIGHMARK

National Provider Directory

National Provider Directory

Locations

5500 Market St
Ste 90
Youngstown, OH 44512
Phone (330) 726-2502

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1176508800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1235354473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5500 MARKET ST",
            "address_2": "SUITE 90",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445122601",
            "telephone_number": "330-782-7701",
            "fax_number": "330-782-8785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5500 MARKET ST",
            "address_2": "SUITE 90",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445122601",
            "telephone_number": "330-782-7701",
            "fax_number": "330-782-8785"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOTAL CARE PSYCHOLOGICAL & COUNSELING SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WALLER",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "NEWELL",
        "authorized_official_title_or_position": "PSYCHOLOGIST",
        "authorized_official_telephone_number": "330-782-7701",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "OH",
            "license": "4312",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7972009",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "96550",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MHN",
            "identifier": "306089",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "166850",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRI CARE",
            "identifier": "0027898",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK",
            "identifier": "1445316",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Youngstown, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.