Active NPI
Sally Jane Rall, PSYD
- Clinical Psychologist
- Fairbanks, AK
National Provider Identifier
1790183176
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 1543
- Practice address
- 3406 Adler Ave
Fairbanks, AK 99703 - Phone
- (571) 236-6823
- NPI assigned
- Dec 16, 2014
- Last updated
- Aug 29, 2019
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 137972 | AK | |
| Professional Counselor | 101YP2500X | 178-000147 | IL | |
| Clinical Psychologist | 103TC0700X | 1543 | AL | Primary |
Addresses
Primary practice location
3406 Adler Ave
Fairbanks, AK 99703
Mailing address
3255 Edby Rd
Fairbanks, AK 99709-2657
Phone (571) 236-6823
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | sally.j.rall.civ@mail.mil | Direct |
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 |
|---|---|---|---|
| 137972 | AK | MD | Professional Counselor |
| 178-000147 | IL | MD | Professional Counselor |
| 1543 | AL | MD | Medical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1418688000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1567036800000",
"number": "1790183176",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3255 EDBY RD",
"city": "FAIRBANKS",
"state": "AK",
"postal_code": "997092657",
"telephone_number": "571-236-6823"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3406 ADLER AVE",
"city": "FAIRBANKS",
"state": "AK",
"postal_code": "99703",
"telephone_number": "571-236-6823"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RALL",
"first_name": "SALLY",
"middle_name": "JANE",
"name_prefix": "Dr.",
"credential": "PSYD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-12-16",
"last_updated": "2019-08-29",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "AK",
"license": "137972",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "IL",
"license": "178-000147",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "AL",
"license": "1543",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "sally.j.rall.civ@mail.mil",
"affiliation": "N",
"endpointDescription": "Work email address.",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "General NOT PII",
"address_1": "3406 Adler Ave",
"city": "Fairbanks",
"state": "AK",
"country_code": "US",
"postal_code": "99703",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Fairbanks, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.