DR. PAMELA RENNE WALLEN PSY.D. NPI 1326123225

NPI Information

NPI: 1326123225
Provider Name: DR. PAMELA RENNE WALLEN, PSY.D.
Classification: Psychologist - 103TC0700X
Entity Type: Individual

Specialization: Clinical

Address:
1580 W COLUMBIA ST
FARMINGTON, MO
ZIP 63640
Phone: (573) 760-1365
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DR. Pamela Renne Wallen, PSY.D. is a clinical psychologist in Farmington, MO. The provider is a psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems. DR. Pamela Renne Wallen, PSY.D. NPI is 1326123225. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1580 W COLUMBIA ST
FARMINGTON, MO
ZIP 63640-512
Phone: (573) 760-1365
Fax: (573) 760-0354

The enumeration date for this NPI number is 10/26/2006 and was last updated on 2/21/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	103TC0700X	Psychologist	Clinical	2001013763	MISSOURI	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	167106	OTHER	MISSOURI	BLUE CROSS BLUE SHIELD
2	614085	OTHER	MISSOURI	HEALTH LINK
3	7994334	OTHER	MISSOURI	AETNA
4	000021719	MEDICARE ID-TYPE UNSPECIFIED	MISSOURI
5	495281511	MEDICAID	MISSOURI

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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