Kristen Wallace

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Practice address

135 Beaver St Ste 402
Waltham, MA 02452-8463

Phone

(740) 214-1926

Fax

(323) 577-6804

NPI assigned

Aug 15, 2023

Last updated

Aug 15, 2023By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Rising Above LLC

  • Behavior Analyst
  • Waltham, MA
  • NPI 1720700248
  NPD

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

{
    "created_epoch": "1692057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692057600000",
    "number": "1992588867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 BEAVER ST STE 402",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "024528463",
            "telephone_number": "740-214-1926",
            "fax_number": "323-577-6804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 BEAVER ST STE 402",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "024528463",
            "telephone_number": "740-214-1926",
            "fax_number": "323-577-6804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "KRISTEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-15",
        "last_updated": "2023-08-15",
        "certification_date": "2023-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Walgreen Eastern Co Inc (Walgreens #02669)
• Alifia Waliji-Banglawala, PHARM.D.
• Krystie Lee Zoch Walker
• Savannah Skye Walker, LCSW
• Stacy Walker, FNP-BC
• Samuel Joseph Walsh, MA
• Waltham Behavioral Health LLC
• Waltham Chiropractic PC
• Waltham Committee, Inc (WCI-Work Community Independence)
• Waltham Dental Group

• Behavior Analyst in Waltham, MA
• Providers in Waltham, MA by specialty
• Behavior Analyst in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2023; 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.