WALLACE POND (PHD) – Mental Health Counselor, NPI 1154031664

WALLACE POND (PHD) is a healthcare provider. based in Colorado springs, Colorado. specializing in MENTAL HEALTH COUNSELOR. They hold the professional credentials PHD. The NPI Number for WALLACE POND (PHD) is 1154031664

Main info

Male
Sole Proprietor
3 Years Of Experience
Accepts Medicare Assignment
Name
WALLACE POND (PHD)
NPI
1154031664
Phone
(719) 344-8195
Address
5390 N Academy Blvd Ste 330
Enumeration Date
25 November 2022
Last Update Date
9 February 2026

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9702523200
Graduation Year
2023 (3 years ago)
PAC ID
4082102637
Group Practice PAC ID
9133011802
Professional Enrollment ID
I20251024000815
Address ID
CO812302244GU710XXSTXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience21
Completeness85
Years active:3State licenses:0Digital endpointsOther names

2,207 MENTAL HEALTH COUNSELOR in CO

Provider Addresses for WALLACE POND (PHD)

  • 5390 N Academy Blvd Ste 330

    Colorado Springs, CO 809184176

    Phone: (719) 344-8195

    Type: Location

  • PO BOX 1328

    DURANGO, CO 813021328

    Phone: (970) 335-2342

    Fax: (970) 335-2438

    Type: Mailing

  • 710 N TAYLOR ST

    GUNNISON, CO 812302244

    Phone: (970) 252-3200

    Fax: (970) 259-2438

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-10-24

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20251024000815IMental Health CounselorCOTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 80918)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 9133011802View full group profile

Reviews

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Frequently asked questions

What is the 10-digit NPI for WALLACE POND (PHD)?
WALLACE POND (PHD) — NPI 1154031664 — is the standard way to identify this listing.
Does the file indicate WALLACE POND (PHD) is practicing under active NPI?
Directory data currently reports WALLACE POND (PHD) as active.
What is WALLACE POND (PHD)'s specialty?
The listing groups WALLACE POND (PHD) with Mental Health Counselor. Clinical services aligned with this taxonomy classification.
What area does WALLACE POND (PHD) serve?
WALLACE POND (PHD)'s listing highlights Colorado Springs, Colorado; more addresses can appear in NPPES.
How many locations tie to this NPI?
3 practice locations appear in the available data.

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