Jenna E. Wallace, PSYD
NPI 1619364346ActiveIndividual· Psychologist· Hurricane, WV
Psychologist (PSYD) in Hurricane, West Virginia, with an NPI issued in April 2015. Enrolled in Medicare as practitioner - clinical psychologist.
Overview
| NPI | 1619364346 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | PSYD |
| Sole proprietor | Yes |
| NPI issued | Apr 21, 2015 |
| Last updated in NPPES | Apr 8, 2022 |
| Certified by provider | Apr 8, 2022 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Psychologist Primary | 103T00000X | — | WV |
| Student in an Organized Health Care Education/Training Program | 390200000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Clinical Psychologist (WV) |
|---|
Other Psychologist providers in Hurricane
- 1568031185
- 1851479885
- 1831218999
- 1235359860
- 1104239821