KATHERINE CHANDLER WALLACE (NPI# 1518261312) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518261312 |
| Entity Type | Individual |
| Full Name | KATHERINE CHANDLER WALLACE |
| Credential | PMHCNS-BC |
| Practice Address |
1611 Cambridge St Cambridge MA 02138-4302 |
| Mailing Address |
50 Hall St Apt 1 Jamaica Plain MA 02130-3220 |
| Practice Telephone | 6176615515 |
| Mailing Telephone | 9785025804 |
| Enumeration Date | 2011-01-07 |
| Last Update Date | 2011-01-07 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 364SP0809X |
Clinical Nurse Specialist Specialization: Psych/Mental Health, Adult |
RN274714 | MA | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932734886 | Katherine Abigail Wallace | Registered Nurse | 43 Cottage St, Milbridge, ME 04658-3534 | 2020-03-10 |
| 1548650617 | Katherine Marie Wallace | Nurse Practitioner | 118 Enterprise Ct Ste B, Columbus, GA 31904-9228 | 2015-01-28 |
| 1942583893 | Katherine Sue Wallace | Counselor | 408 S Gideon Ave, Gideon, MO 63848-9200 | 2011-09-27 |
| 1801385349 | Katherine H Wallace | Social Worker | 600 Jackson St, Fredericksburg, VA 22401-5719 | 2018-05-09 |
| 1891190831 | Katherine Lucas Wallace | Marriage & Family Therapist | 3800 Coolidge Ave, Oakland, CA 94602-3311 | 2014-11-04 |
| 1124395603 | Katherine J Wallace | Nutritionist | 675 W Washington Ave, Madison, WI 53703-2637 | 2011-11-28 |
| 1851516371 | Katherine G. Wallace | Marriage & Family Therapist | 147 County Rd, Gorham, ME 04038-1916 | 2007-04-17 |
| 1750438883 | Katherine Ann Wallace | Physical Therapist | 5901 Roosevelt Way Ne, Suite B, Seattle, WA 98105-2754 | 2007-01-04 |
| 1790843381 | Katherine Ahn Wallace | Dentist | 7801 Center Ave, Suite 101, Huntington Beach, CA 92647-9110 | 2006-12-05 |
| Street Address |
1611 CAMBRIDGE ST |
| City | CAMBRIDGE |
| State | MA |
| Zip Code | 02138-4302 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598747412 | Margaret Rose Barsam | Pediatrics | 1611 Cambridge St, Cambridge, MA 02138-4302 | 2005-11-16 |
| 1295218501 | Seema Mitesh Patel | Pharmacist | 1611 Cambridge St, Cambridge, MA 02138-4302 | 2018-09-12 |
| 1104311737 | Maura Jean Dipietro | Registered Nurse | 1611 Cambridge St, Cambridge, MA 02138-4302 | 2018-06-26 |
| 1841678299 | Atrius Health, Inc. | Chiropractor | 1611 Cambridge St, Cambridge, MA 02138-4302 | 2015-05-18 |
| 1851725246 | Natalie Ann Briggs | Physical Therapist | 1611 Cambridge St, Cambridge, MA 02138-4302 | 2013-08-21 |
| 1437494267 | Clarence Theodore Dennis | Nurse Practitioner | 1611 Cambridge St, Cambridge, MA 02138-4302 | 2012-12-05 |
| 1043561616 | Bronwyn Kate Mastrangelo | Physician Assistant | 1611 Cambridge St, Cambridge, MA 02138-4302 | 2012-09-24 |
| 1821347865 | Kathryn Marie Kahn | Registered Nurse | 1611 Cambridge St, Cambridge, MA 02138-4302 | 2012-09-06 |
| 1316295801 | Jacqueline Marie Burke | Pharmacist | 1611 Cambridge St, Cambridge, MA 02138-4302 | 2012-08-15 |
| 1821373671 | David Johnson | Nurse Practitioner | 1611 Cambridge St, Harvard Vanguard Medical Associates, Bh Dept., Cambridge, MA 02138-4302 | 2011-10-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922618610 | Khushboo Vijay Bhatia | Student in an Organized Health Care Education/Training Program | Internal Medicine Residency Program, Mount Auburn Hospi, 330 Mt. Auburn Street, Cambridge, MA 02138 | 2020-08-06 |
| 1780204156 | Ashna Grover | Student in an Organized Health Care Education/Training Program | 330 Mt Auburn Street Mount Auburn Hospital, Internal Medicine Residency Program, Cambridge, MA 02138 | 2020-04-25 |
| 1790330298 | Cambridge Periodontics LLC | Dentist | 1692 Massachusetts Ave Ste 3, Cambridge, MA 02138 | 2019-08-02 |
| 1295389765 | Yulia Levit | Technician/Technologist | 1208 Massachussets Av, Cambridge, MA 02138 | 2019-08-01 |
| 1720645393 | Chinmay Tusharkumar Jani | Student in an Organized Health Care Education/Training Program | Mount Auburn Hospital, 330 Mt Auburn Street, Cambridge, MA 02138 | 2019-05-20 |
| 1386209831 | Alexander Ryan Walker | Internal Medicine | 300 Mount Auburn Street Mount Auburn Hospital, Dept. of Medicine, Cambridge, MA 02138 | 2019-05-09 |
| 1659844868 | Aimee Hsieh | Social Worker | 525 Mount Auburn Street, Cambridge, MA 02138 | 2019-01-10 |
| 1043733389 | Armida Fruzzetti | Psychologist | 900 Concord Avenue, Cambridge, MA 02138 | 2017-07-19 |
| 1174984827 | Jenna Mezin Schmid | Psychologist | 75 Mt Auburn St 4 East, Harvard University Health Services, Cambridge, MA 02138 | 2016-03-09 |
| 1316313208 | Kelly Abbott | Optometrist | 12 Eliot St., Cambridge, MA 02138 | 2015-08-14 |
| Find all providers in zip 02138 | ||||
| Taxonomy Code | 364SP0809X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Clinical Nurse Specialist |
| Specialization | Psych/Mental Health, Adult |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568594497 | Beth Ann Good | Clinical Nurse Specialist | 145 2nd Ave Se, Cambridge, MN 55008 | 2007-03-09 |
| 1225163777 | Susan Therese Morgan | Clinical Nurse Specialist | 6 Bigelow St, Cambridge, MA 02139 | 2007-02-23 |
| 1396721866 | Marsha Louise Gilmore | Clinical Nurse Specialist | 1575 Cambridge St, Youville Hospital, Cambridge, MA 02138-4398 | 2005-12-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053935809 | Anne-marie Barron | Clinical Nurse Specialist | 9 Kahler Ave, Milton, MA 02186-1519 | 2020-06-07 |
| 1306467139 | Kathleen Mary Daly | Clinical Nurse Specialist | 22 Priscilla Ln, Duxbury, MA 02332-5101 | 2020-05-04 |
| 1407325541 | New Directions Behavioral Health LLC | Clinical Nurse Specialist | 10 Ash St, Danvers, MA 01923-2749 | 2018-11-19 |
| 1457894628 | Psyche1001 Learn Grow Change LLC | Clinical Nurse Specialist | 638 Adamsville Rd, Suite 1001, Westport, MA 02790-5031 | 2016-11-21 |
| 1841642725 | Joyce Daqnal Shields | Clinical Nurse Specialist | 132 Oakley Rd, Belmont, MA 02478-2734 | 2016-07-05 |
| 1386004075 | Jane Bloom | Clinical Nurse Specialist | 95 Golden Hill, Lee, MA 01238-9132 | 2016-02-24 |
| 1255722716 | Carol Vivori | Clinical Nurse Specialist | 132 Mass Moca Way, North Adams, MA 01247-2446 | 2015-02-05 |
| 1982995262 | Linda Louise Darbyshire | Clinical Nurse Specialist | 60 Munson Meeting Way Ste I, Psychiatric Collaborative, Chatham, MA 02633-1992 | 2011-04-21 |
| 1093020091 | Suzanne Elizabeth Bergeron | Clinical Nurse Specialist | 2 Administration Rd, Bridgewater, MA 02324-3230 | 2010-08-13 |
| 1467774356 | Mindful Wellbeing, LLC | Clinical Nurse Specialist | 11 Jillson Way, East Sandwich, MA 02537-1265 | 2010-02-19 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.