CAROLYN ANN WALLACE (NPI# 1023141363) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023141363 |
| Entity Type | Individual |
| Full Name | CAROLYN ANN WALLACE |
| Credential | LCPCC, CADC, MS |
| Practice Address |
25 Middle St Portland ME 04101-4869 |
| Practice Telephone | 2076533999 |
| Mailing Telephone | 2076533999 |
| Enumeration Date | 2007-03-14 |
| Last Update Date | 2009-01-27 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
LC4223 | ME | Behavioral Health & Social Service Providers |
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
XL3204 | ME | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306470455 | Carolyn Ann Wallace | Counselor | 2600 W Broadway, Louisville, KY 40211-1366 | 2020-02-27 |
| 1356547509 | Carolyn Wallace | Counselor | 1400 Hensley Dr, Tahlequah, OK 74464-5221 | 2007-06-25 |
| 1962595835 | Carolyn Wallace | Social Worker | 50 Pleasant St, Northampton, MA 01060-3909 | 2006-10-02 |
| Street Address |
25 MIDDLE ST |
| City | PORTLAND |
| State | ME |
| Zip Code | 04101-4869 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376501833 | Joel Guarna | Psychologist | 25 Middle St, Portland, ME 04101-4212 | 2006-05-03 |
| 1417558792 | Amy H Reynolds | Social Worker | 25 Middle St, Portland, ME 04101-4869 | 2020-11-04 |
| 1720699333 | Agape Inc. | Clinic/Center | 25 Middle St, Portland, ME 04101-4869 | 2020-08-17 |
| 1619588407 | Kelley Barton Newkirk | Social Worker | 25 Middle St, Portland, ME 04101-4869 | 2020-08-14 |
| 1881216489 | Stacy Karp Mosher | Counselor | 25 Middle St, Portland, ME 04101-4869 | 2020-05-18 |
| 1699315754 | Leslie Connolly, P.a. | Social Worker | 25 Middle St, Portland, ME 04101-4869 | 2020-01-07 |
| 1861869562 | Erik R Olander | Counselor | 25 Middle St, Portland, ME 04101-4869 | 2015-08-28 |
| 1982048716 | Mark Nakell | Counselor | 25 Middle St, Portland, ME 04101-4869 | 2013-04-23 |
| 1154764264 | David Paul Veillette | Counselor | 25 Middle St, Portland, ME 04101-4869 | 2013-04-09 |
| 1265704837 | Stephen Robert Andrew | Counselor | 25 Middle St, Portland, ME 04101-4869 | 2012-01-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306450655 | Jocylin Egan | Nurse Practitioner | 442 Congress Street, 2nd Floor, Portland, ME 04101 | 2020-09-03 |
| 1255963559 | Portcity Home Healthcare LLC | In Home Supportive Care | 525 Forest Avenue, Suite 8, Portland, ME 04101 | 2020-02-05 |
| 1578101929 | Mohamed Hassan Mohamed | Student in an Organized Health Care Education/Training Program | 75 Lancaster St Ste 218a, Portland, ME 04101 | 2019-12-17 |
| 1841855301 | Portland Opioid Health Home | Counselor | 48 Free St., Mezzanine Level, Portland, ME 04101 | 2019-05-09 |
| 1093379224 | Alexandra Strawbridge Maurer | Acupuncturist | 50 A Cove Street, Portland, ME 04101 | 2019-04-23 |
| 1245719541 | Scott J Whited | Nurse Practitioner | 216 Vaughan St., Mcgeachy Hall, Portland, ME 04101 | 2018-08-08 |
| 1144733064 | Alixandria Elaine Marie Winchell | Massage Therapist | One City Center, Portland, ME 04101 | 2017-11-14 |
| 1417473638 | Rachel S Schwaner | Occupational Therapist | 78 Danforth Street, Apartment 6, Portland, ME 04101 | 2017-08-18 |
| 1023538154 | Derina Boothroyd | Audiologist-Hearing Aid Fitter | 985 Forest Ave., Portland, ME 04101 | 2017-06-20 |
| 1881123297 | Mark Mccullough | Social Worker | 57 Exchange Street, Suite 403, Portland, ME 04101 | 2017-06-08 |
| Find all providers in zip 04101 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336748243 | Jessica M Feinsmith | Counselor | 6530 N Williams Ave, Portland, OR 97217-1924 | 2020-10-21 |
| 1720687809 | Karissa Myriah Gregory | Counselor | 14255 Se Rupert Dr, Portland, OR 97267-1211 | 2020-10-20 |
| 1528667904 | Zuzana Sakova | Counselor | 819 Se Morrison St Ste 225, Portland, OR 97214-6311 | 2020-10-18 |
| 1891302238 | Nina Landey | Counselor | 120 Se 53rd Ave, Portland, OR 97215-1204 | 2020-09-29 |
| 1902412166 | Peter H Addy LLC | Counselor | 524 N Tillamook St Ste 102b, Portland, OR 97227-1993 | 2020-09-22 |
| 1326654765 | Naomi Painter | Counselor | 1925 Ne 19th Ave Apt 8a, Portland, OR 97212-4526 | 2020-09-21 |
| 1750996104 | Sara Fuller | Counselor | 3016 Ne 70th Ave, Portland, OR 97213-5802 | 2020-09-12 |
| 1114532983 | Matthew W Cronin | Counselor | 1122 Ne 122nd Ave Ste 200, Portland, OR 97230-2081 | 2020-09-09 |
| 1447865381 | Luke Colbourn | Counselor | 2705 E Burnside St Ste 206, Portland, OR 97214-1768 | 2020-09-08 |
| 1710599774 | Abigail Kathryn Ernst | Counselor | 1020 Sw Taylor St # 100, Portland, OR 97205-2543 | 2020-08-20 |
| Find all providers in PORTLAND | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.