Anna Waller, PHD

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

RPO117461 Issued in NY

Practice address

333 E 34TH St
Apt 9G
New York, NY 10016-4977

Phone

(212) 689-1048

Fax

(646) 398-9367

NPI assigned

Jul 25, 2006

Sex

Female

Sole proprietor

Yes

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

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Jan 1, 2015 through Jan 1, 2027

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1408406400000",
    "number": "1568485506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 E 34TH ST",
            "address_2": "APT 9G",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100165231",
            "telephone_number": "212-689-1048",
            "fax_number": "646-398-9367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 E 34TH ST",
            "address_2": "APT 9G",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100164977",
            "telephone_number": "212-689-1048",
            "fax_number": "646-398-9367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLER",
        "first_name": "ANNA",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-25",
        "last_updated": "2014-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "RPO117461",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Steven Gregg Wallach, MD
• Thomas Wallach, MD
• Alison D Wallack, M.S.
• Joel J Wallack, M.D.
• Marc Kenneth Wallack, M.D.
• John Felix Waller, M.D.
• Leslie A Waller I, LCSW-RP
• Samantha Waller
• Alexa Rose Wallerstein, LMHC
• Avery Wallerstein

• Clinical Social Worker in New York, NY
• Providers in New York, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.