Carly Rosemary Frances Wallace

Primary specialty

PsychologistTaxonomy code 103T00000X

License

4133-57 Issued in WI

Practice address

1919 W North Ave Ste 200
Milwaukee, WI 53205-1101

Phone

(414) 257-7610

NPI assigned

Sep 10, 2026

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

Other names 1

• Carly Rosemary Frances Barry Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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

{
    "created_epoch": "1788998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788998400000",
    "number": "1679483820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "W236S7800 WESTWOOD DR",
            "city": "BIG BEND",
            "state": "WI",
            "postal_code": "531039408",
            "telephone_number": "414-257-7610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1919 W NORTH AVE STE 200",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532051101",
            "telephone_number": "414-257-7610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "CARLY",
        "middle_name": "ROSEMARY FRANCES",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-09-10",
        "last_updated": "2026-09-10",
        "certification_date": "2026-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WI",
            "license": "4133-57",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CARLY",
            "last_name": "BARRY",
            "middle_name": "ROSEMARY FRANCES",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Terri Lynn Walker, RN
• Jill A Wall, APNP
• John P. Wall, M.D.
• Meghan Anna Wall, PH.D.
• Brian Ken Wallace, MD
• Christian Alexander Wallace, PA-C
• Courtney Wallace, APSW
• Dominique Wallace
• Francheska Wallace
• Latrice Shemon Wallace, RN

• Psychologist in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Psychologist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.