Darah Elaine Wallsten, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

4156 Issued in HI

Practice address

636 Church St Ste 405
Evanston, IL 60201-4580

Phone

(847) 250-9959

Fax

(847) 306-8118

NPI assigned

Nov 3, 2011

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

Medicare fee-for-service enrollment

Enrolled in HI

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.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Kaiser Foundation Health Plan Inc

  • Radiology Clinic/Center
  • Honolulu, HI
  • NPI 1063515567
  Medicare reassignment NPD
• Kaiser Foundation Health Plan Inc

  • Clinical Medical Laboratory
  • Kealakekua, HI
  • NPI 1326336041
  NPD
• Kaiser Foundation Health Plan, Inc

  • Rural Health Clinic/Center
  • Kahuku, HI
  • NPI 1245773936
  NPD

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

{
    "created_epoch": "1320278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748995200000",
    "number": "1831476985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16-566 KEAAU PAHOA RD # 614",
            "city": "KEAAU",
            "state": "HI",
            "postal_code": "967498137",
            "telephone_number": "808-756-5030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "636 CHURCH ST STE 405",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602014580",
            "telephone_number": "847-250-9959",
            "fax_number": "847-306-8118"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16-566 Keaau Pahoa Rd # 614",
            "address_purpose": "LOCATION",
            "city": "Keaau",
            "state": "HI",
            "postal_code": "967498137",
            "country_code": "US",
            "telephone_number": "808-756-5030",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALLSTEN",
        "first_name": "DARAH",
        "middle_name": "ELAINE",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-03",
        "last_updated": "2025-06-04",
        "certification_date": "2025-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071.021040",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "HI",
            "license": "4156",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NC",
            "license": "4187",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Camilla Wallace, LCSW
• Joseph Eli Wallach, PH.D.
• Luke Wallens
• Benjamin S. Wallis, MD
• Julian Wallis
• Jennifer Walsh, CRNA
• Matthew Walsh, LSW
• Maureen Elizabeth Walsh, FNP
• Nora Josephine Walsh, LCSW
• Olga Maria Walsh

• Clinical Psychologist in Evanston, IL
• Providers in Evanston, IL by specialty
• Clinical Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2025; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.