Carli Reed Waller

Primary specialty

CounselorTaxonomy code 101Y00000X

Practice address

415 S Portage Path
Akron, OH 44320-2327

Phone

(330) 253-4597

NPI assigned

Jan 26, 2016

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

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Vantage Aging

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Akron, OH
  • NPI 1548222656
  NPD (past)

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

{
    "created_epoch": "1453766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453766400000",
    "number": "1881051597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 14TH ST NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447033008",
            "telephone_number": "330-844-6624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 S PORTAGE PATH",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443202327",
            "telephone_number": "330-253-4597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLER",
        "first_name": "CARLI",
        "middle_name": "REED",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-01-26",
        "last_updated": "2016-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erin Wallace, LISW
• Latoska Wallace
• Randy Lamar Wallace Jr., M.D.
• Ryan James Wallace
• Sherrie S Wallace, D.P.M
• Brianna Wallis, DO
• Adam Brent Walls I
• Janae Walls
• Taylor Walls
• Cameron Rose Walsh, LPC

• Counselor in Akron, OH
• Providers in Akron, OH by specialty
• Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2016; 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.