Norah Suzanne Wallace

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

025328 Issued in NY

Practice address

138 W 25TH St FL 11
New York, NY 10001-7405

Phone

(646) 770-3518

NPI assigned

Jun 9, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1654732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707955200000",
    "number": "1326777871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "138 W 25TH ST FL 11",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100017405",
            "telephone_number": "646-770-3518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "138 W 25TH ST FL 11",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100017405",
            "telephone_number": "646-770-3518"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "NORAH",
        "middle_name": "SUZANNE",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-09",
        "last_updated": "2024-02-15",
        "certification_date": "2024-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NJ",
            "license": "35SI00732000",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "P113414",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "025328",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://thereedscenter.com/",
            "affiliation": "Y",
            "endpointDescription": "The Reeds Center",
            "affiliationName": "The Reeds Center",
            "address_1": "7 W 36th St",
            "city": "New York",
            "state": "NY",
            "country_code": "US",
            "postal_code": "100187911",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Meri Diane Wallace, LCSW
• Michelle Wallace
• Nancy E Wallace, LMSW
• Natalie Wallace, LCSW
• Nathan John Wallace, MD
• Rachel Wallace
• Racquel Elizabeth Wallace, MFT
• Sybille Wallace, M.D.
• Andrew Brian Wallach, MD
• Elizabeth Wallach, M.D.

• Clinical Psychologist in New York, NY
• Providers in New York, NY by specialty
• Clinical Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 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.