IndividualActive
Eric Wallace, PHD
NPI 1912409160 · Counseling Psychologist · Shaker Heights, OH
Provider details
- NPI number
- 1912409160
- Entity type
- Individual
- Primary specialty
- Counseling PsychologistBehavioral Health & Social Service Providers
- Credential
- PHD
- Sex
- Male
- Sole proprietor
- No
- License
- P.07864 (OH)
Practice location
22001 Fairmount Blvd
Shaker Heights, OH 44118-4819
Phone: (216) 320-8456
Mailing address
22001 Fairmount Blvd
Shaker Heights, OH 44118-4819
Registry dates
- Enumerated
- 2018-03-05
- Last updated
- 2019-03-20
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.