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Deactivated NPI 1902938558 Deactivated / Inactive NPI Female Practitioner

Triphinia M Wallace , PSY

Psychologist • Brookhaven, GA

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Triphinia Wallace has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date March 09, 2007
NPI Deactivation Date August 17, 2022
Total Practice Duration ~15 Years of Practice (2007 – 2022)

Professional Overview & Biography Verified Profile Summary

Triphinia Wallace, PSY was a registered Psychologist practicing in Brookhaven, GA. Throughout an active medical career spanning 15 years, Triphinia Wallace provided care at the practice location at 4062 PEACHTREE RD NE # 190A until profile deactivation on 2022-08-17.

Practice Location & Contact Primary Location

Practice Address

4062 Peachtree Rd Ne # 190a

Brookhaven, GA 303193021

Telephone 4043172283
Fax 4043936692
Associated Practice Facility / Clinic
🏢 Gathering Precious Stones Llc Facility NPI 1992083067

Specialty Benchmarks & Practice Insights

Comparative analytics for Psychologist in Brookhaven, GA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.0 Yrs
State Avg: 27.3 Yrs
Regional Practice Density
7 Specialists

Practicing in Brookhaven, GA (941 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2025-03-14
Psychologist Primary Specialty

NUCC Taxonomy Code: 103T00000X

State License GA GA003723

A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

14 Historical Events
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Updated Practice Location March 14, 2025

Registered at 4062 PEACHTREE RD NE # 190A, BROOKHAVEN, GA 303193021 (Tel: 4043172283)

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Updated Business Mailing Address March 14, 2025

Registered at 4062 PEACHTREE RD NE # 190A, BROOKHAVEN, GA 303193021 (Tel: 4043172283)

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Medical Taxonomy / Specialty Registered (Primary Specialty) March 14, 2025

Psychologist (License #GA003723 in GA)

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Updated Practice Location November 15, 2022

Registered at 8800 ROSWELL RD., STE. A135, SANDY SPRINGS, GA 30350 (Tel: 4046821923)

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Updated Business Mailing Address November 15, 2022

Registered at 1000 JEFFERSON ST., STE. 2C, LYNCHBURG, VA 24504 (Tel: 6173790496)

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Provider Name / Credentials Updated November 15, 2022

Recorded as TRIPHINIA WALLACE, PSY.

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Medical Taxonomy / Specialty Registered (Primary Specialty) November 15, 2022

Counselor (License #LPC003793 in GA)

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NPI Profile Deactivated August 17, 2022

Record deactivated on August 17, 2022

NPI Profile Active April 13, 2015

NPI status registered as active in NPPES database

📍
Updated Practice Location April 13, 2015

Registered at 8800 ROSWELL RD., STE. A135, SANDY SPRINGS, GA 30350 (Tel: 4046821923)

📍
Updated Business Mailing Address April 13, 2015

Registered at 1000 JEFFERSON ST., STE. 2C, LYNCHBURG, VA 24504 (Tel: 6173790496)

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Provider Name / Credentials Updated April 13, 2015

Recorded as TRIPHINIA WALLACE, PSY.

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Medical Taxonomy / Specialty Registered (Primary Specialty) April 13, 2015

Counselor (License #LPC003793 in GA)

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Initial NPI Registration & Enumeration March 09, 2007

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1902938558
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: March 09, 2007
Last Update: March 14, 2025
Deactivation Date: August 17, 2022
Sole Proprietor: No

Mailing Address

4062 Peachtree Rd Ne # 190a

Brookhaven, GA 303193021

Phone: 4043172283

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.