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Organization

TOTAL CARE PSYCHOLOGICAL & COUNSELING SERVICES INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. MARY NEWELL WALLER PHD (PSYCHOLOGIST)
(330) 782-7701
Entity
Organization

Contact information

Practice address
5500 MARKET ST, SUITE 90, YOUNGSTOWN, OH 44512-2601
(330) 782-7701
(330) 782-8785
Mailing address
5500 MARKET ST, SUITE 90, YOUNGSTOWN, OH 44512-2601
(330) 782-7701
(330) 782-8785

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
4312
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0027898
TRI CARE
OH
01
1445316
HIGHMARK
OH
01
166850
ANTHEM
OH
01
306089
MHN
OH
01
7972009
AETNA
OH
01
96550
CIGNA
OH
Enumeration date
04/14/2007
Last updated
08/22/2020
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