Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1689768707 Individual Practitioner Male Practitioner

Randall Dean Wallace , MS

Psychologist • Cambridge, MN

Professional Overview & Biography Verified Profile Summary

Randall Wallace, MS is a registered healthcare professional specializing in Psychologist in Cambridge, MN. Practice services are available at 133 2ND AVE SW under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

133 2nd Ave Sw

Cambridge, MN 550081552

Telephone 7636899407
Fax 7635520164
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Psychologist in Cambridge, MN

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 22.0 Yrs
State Avg: 22.6 Yrs
Regional Practice Density
9 Specialists

Practicing in Cambridge, MN (1833 Statewide)

Telehealth Adoption Rate
22.2% 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

Psychologist Primary Specialty

NUCC Taxonomy Code: 103T00000X

State License MN LP0683

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.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

11 Associated Practitioners
Suzanne Wenstrom Pocrnich , MS, LP

Psychologist - Counseling

NPI 1053434159

Master of Science, Licensed Psychologist

Jon Marlton , LMFT

Marriage & Family Therapist

NPI 1104162163

Licensed Marriage and Family Therapist

Danielle Hjort , MA, LPCC

Counselor - Professional

NPI 1255624854

Master of Arts, Licensed Professional Clinical Counselor

Heather Martin , LMFT

Marriage & Family Therapist

NPI 1366504961

Licensed Marriage and Family Therapist

NPI 1396825089

Master of Arts

Katherine Routt , LMFT

Marriage & Family Therapist

NPI 1427110097

Licensed Marriage and Family Therapist

Career & Practice History Timeline

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

6 Historical Events
NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

📍
Updated Practice Location July 08, 2007

Registered at 133 2ND AVE SW, CAMBRIDGE, MN 550081552 (Tel: 7636899407)

📍
Updated Business Mailing Address July 08, 2007

Registered at 199 COON RAPIDS BLVD NW, SUITE 306, COON RAPIDS, MN 554335831 (Tel: 7637801520)

👤
Provider Name / Credentials Updated July 08, 2007

Recorded as RANDALL WALLACE, M.S.

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Psychologist (License #LP0683 in MN)

🟢
Initial NPI Registration & Enumeration October 03, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

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NPI Administrative Meta

NPI Number: 1689768707
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: October 03, 2006
Last Update: July 08, 2007
Sole Proprietor: No

Mailing Address

199 Coon Rapids Blvd Nw, Suite 306

Coon Rapids, MN 554335831

Phone: 7637801520

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.