MARISA WALLACE (NPI# 1316417439) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316417439 |
| Entity Type | Individual |
| Full Name | MARISA WALLACE |
| Credential | LPC |
| Practice Address |
23780 Farringdon Ave Euclid OH 44123-1537 |
| Practice Telephone | 2162401111 |
| Mailing Telephone | 2162401111 |
| Enumeration Date | 2018-12-01 |
| Last Update Date | 2019-08-27 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YP2500X |
Counselor Specialization: Professional |
C.190690 | OH | Behavioral Health & Social Service Providers |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144248162 | Marisa I Wallace | Nurse Practitioner | 423 E 23rd St, New York, NY 10010-5011 | 2006-07-17 |
| Street Address |
23780 FARRINGDON AVE |
| City | EUCLID |
| State | OH |
| Zip Code | 44123-1537 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932502176 | Adrian Thompson Sr. | Driver | 23206 Gay Street, Euclid, OH 44123 | 2014-10-02 |
| 1942611058 | Christine Anderson | Licensed Practical Nurse | 24151 Devoe Ave, Euclid, OH 44123 | 2014-05-12 |
| 1396175352 | Shrease Sims | Clinical Nurse Specialist | 20890 Wilmore Ave, Euclid, OH 44123 | 2013-11-12 |
| 1588916035 | A Better Way Health Care Services of Ohio, Inc. | Home Health | 23800 Puritan Rd, Euclid, OH 44123 | 2012-10-09 |
| 1053616532 | D.d.c.t. Enterprises | In Home Supportive Care | 24455 Lakeshore Blvd Apt 423, Euclid, OH 44123 | 2011-01-14 |
| 1528384559 | J & C Medical Supply Company | Durable Medical Equipment & Medical Supplies | 24451 Lakeshore Blvd, Suite 1503 West, Euclid, OH 44123 | 2010-04-15 |
| 1770808628 | Lakia Johnson | Registered Nurse | 901 East 223rd Street, Euclid, OH 44123 | 2010-04-05 |
| 1356670673 | Sheriece Corlynn Stewart | Registered Nurse | 246 E.216th St, Euclid, OH 44123 | 2009-12-16 |
| 1689803140 | Dawnyele Tay St. Leone | Massage Therapist | 22308 Lake Shore Blvd., Euclid, OH 44123 | 2009-07-06 |
| 1073764999 | Samantha Ann Kuhn | Massage Therapist | 22308 Lakeshore, Euclid, OH 44123 | 2008-10-09 |
| Find all providers in zip 44123 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306205190 | Consuelo Parker | Counselor | 27110 Lake Shore Blvd, Euclid, OH 44132-1244 | 2016-02-22 |
| 1821238510 | Laverne Wilcox | Counselor | 1798 Cedar Ct, Euclid, OH 44117 | 2009-02-20 |
| 1932210390 | Denise Collins | Counselor | 20690 Lakeland Blvd, Euclid, OH 44119-3241 | 2006-08-31 |
| 1013489186 | Abigail Schneider | Counselor | 22639 Euclid Ave, Euclid, OH 44117-1622 | 2018-12-29 |
| 1326510173 | Henrietta Lorei | Counselor | 27801 Euclid Ave Ste 520, Euclid, OH 44132-3500 | 2018-12-18 |
| 1366933590 | Yolander Wilson | Counselor | 26250 Euclid Ave Ste 415, Euclid, OH 44132-3690 | 2018-05-23 |
| 1609366681 | Tawatha A Hurst | Counselor | 26250 Euclid Ave Ste 415, Euclid, OH 44132-3690 | 2018-05-15 |
| 1457867384 | William Thomas Zaffiro Jr. | Counselor | 22639 Euclid Ave, Euclid, OH 44117-1622 | 2017-12-14 |
| 1568980902 | Brittani Davis | Counselor | 22639 Euclid Ave, Euclid, OH 44117-1622 | 2017-09-06 |
| 1659400158 | Marcia Joan Bremenour | Counselor | 20690 Lakeland Blvd, Euclid, OH 44119-3241 | 2007-03-02 |
| Find all providers in EUCLID | ||||
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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.