Type 1 · Individual ✓ Active NPI ✓ Valid NPI checksum

Stacey Waller, PH.D.

Clinical Psychologist in Charleston, WV · enumerated 2006.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1114990900

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Registry record

Entity type Individual (Type 1)

Name Stacey Waller

Credential PH.D.

Sex Female

Practice address 1097 Fledderjohn Rd Ste 3, Charleston, WV, 25314

Phone (304) 345-0880

Fax (304) 345-1112

Enumeration date Feb 10, 2006

Last updated in NPPES Jun 4, 2008

Taxonomy & licenses

103TC0700X Clinical Psychologist Behavioral Health & Social Service Providers · License 891 (WV) Primary

PHD · Doctor of Philosophy: A doctoral degree; in healthcare often held by clinical psychologists and researchers. About the PHD credential

Other identifiers

Identifier	Type	State	Issuer
3810001772	Medicaid	WV	-

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

Read the full guide → Validate an NPI →

Frequently asked questions

What is the NPI number for Stacey Waller?

The National Provider Identifier (NPI) for Stacey Waller is 1114990900, a Type 1 (individual) record in the CMS NPPES registry.

Where does Stacey Waller practice?

The practice location on file with NPPES is in Charleston, WV. Providers can have multiple locations; NPPES lists the primary practice address.

Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2008-06-04.