KATHI WALLACE (NPI# 1114319092) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114319092 |
| Entity Type | Individual |
| Full Name | KATHI WALLACE |
| Other Name | MRS. KATHLEEN JENNIFER WALLACE |
| Credential | M.A.; L.C.P.C. |
| Practice Address |
11166 Tesson Ferry Rd. Suite #203 Alpha Omega Christian Counseling St. Louis MO 63123 |
| Practice Telephone | 3148492120 |
| Practice Fax Number | 3147291953 |
| Mailing Telephone | 3148492120 |
| Mailing Fax Number | 3147291953 |
| Enumeration Date | 2015-03-02 |
| Last Update Date | 2015-03-02 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YP2500X |
Counselor Specialization: Professional |
IL#180.009256 | IL | Behavioral Health & Social Service Providers |
| Street Address |
11166 TESSON FERRY RD. SUITE #203 ALPHA OMEGA CHRISTIAN COUNSELING |
| City | ST. LOUIS |
| State | MO |
| Zip Code | 63123 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770002610 | Peter Brown | Home Health Aide | 9530 Antigo Dr, St Louis, MO 63123 | 2017-09-12 |
| 1346629748 | Emily Murray | Community/Behavioral Health | 7556 Genesta Street, Saint Louis, MO 63123 | 2015-05-19 |
| 1730566183 | Family Home & Health Care Services | Home Health | 9124 Lemona Drive, Saint Louis, MO 63123 | 2015-05-05 |
| 1982981098 | Robert Arthur Bilzing | Pharmacist | 9949 Tesson Ferry Rd, St. Louis, MO 63123 | 2011-11-03 |
| 1760767198 | Valentina Jovic | Pharmacist | 5764 South Lindbergh Blvd, St. Louis, MO 63123 | 2011-10-17 |
| 1033423504 | Margaret L Shields Inc | Podiatrist | 11132 South Towne Square, Ste 105, St Louis, MO 63123 | 2010-07-27 |
| 1083858336 | John David Bouhasin | Pediatrics | 7629 Bracken Circle, St. Louis, MO 63123 | 2009-04-29 |
| 1326288929 | Erica J Fahrner | Occupational Therapist | 6022 S. Lindbergh, Suite 100, Saint Louis, MO 63123 | 2009-02-23 |
| 1629248158 | Maria Ramona Eppler | Nurse Practitioner | 4217 Bayless Ave., St. Louis, MO 63123 | 2008-03-12 |
| 1528251337 | Affton Medical Clinic | Internal Medicine | 84 Grasso Plaza, St Louis, MO 63123 | 2007-08-24 |
| Find all providers in zip 63123 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215491329 | Latonya Allen | Counselor | 1612 S. Big Bend Blvd, St. Louis, MO 63117 | 2019-01-23 |
| 1861901480 | Christina Cummings | Counselor | 5387 Pershing Ave., Apt. A, St. Louis, MO 63112 | 2017-09-26 |
| 1225436959 | Shelley Stretch | Counselor | 4066 Dunnica Avenue, St. Louis, MO 63118 | 2014-12-11 |
| 1598169120 | Vivian Carr | Counselor | 5266 Sir Bors Drive, St. Louis, MO 63129 | 2014-10-10 |
| 1639423296 | Daniella Elaine Harris | Counselor | 10000 Watson Rd., Suite 1l3, St. Louis, MO 63126-1843 | 2012-11-05 |
| 1013279157 | Jeanna Rufet Knight | Counselor | 2173 Palestra Drive, Apt. 3, St. Louis, MO 63146 | 2012-06-14 |
| 1679760276 | Joan M Brackmann | Counselor | 3672 B Arsenal St., St. Louis, MO 63116-4821 | 2007-09-27 |
| 1851519409 | Ajuma Kaleem Muhammad | Counselor | 12052 Cato Dr., St. Louis, MO 63033 | 2007-04-20 |
| 1407972250 | Mary E Harper | Counselor | 1066 Executive Parkway Drive, Suite 103, St. Louis, MO 63141 | 2007-03-22 |
| 1376677724 | Michelle Meier | Counselor | 110 N. Elm, St. Louis, MO 63119 | 2007-03-16 |
| Find all providers in ST. LOUIS | ||||
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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.