STEPHANIE L WALLACE (NPI# 1407483878) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407483878 |
| Entity Type | Individual |
| Full Name | STEPHANIE L WALLACE |
| Credential | LMFT |
| Practice Address |
1212 Hancock St Ste 205 Quincy MA 02169-4371 |
| Practice Telephone | 6177500183 |
| Mailing Telephone | 6177500183 |
| Enumeration Date | 2020-03-25 |
| Last Update Date | 2020-03-25 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 106H00000X | Marriage & Family Therapist | 1699 | MA | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225509524 | Stephanie Wallace | Speech-Language Pathologist | 1014 Glen Crossing Rd, Glen Carbon, IL 62034-8517 | 2018-12-11 |
| 1679755003 | Stephanie R Wallace | Occupational Therapy Assistant | 5626 Lasater Dr Nw Apt 5, Canton, OH 44718-1923 | 2007-11-27 |
| 1841289022 | Stephanie R Wallace | Pediatrics | 2405 Research Parkway, Colorado Springs, CO 80918 | 2005-10-19 |
| 1023619061 | Stephanie Lynn Wallace | Pharmacist | 254 Cassidy Blvd, Pikeville, KY 41501-1426 | 2020-11-05 |
| 1750988127 | Stephanie Wallace | Marriage & Family Therapist | 730 Medical Center Ct, Chula Vista, CA 91911-6618 | 2020-10-07 |
| 1427534718 | Stephanie E Wallace | Nurse Anesthetist, Certified Registered | 200 Mercy Circle, Camp Pendleton, CA 92055 | 2018-07-19 |
| 1740791714 | Stephanie Wallace | Genetic Counselor, MS | 6431 Fannin Street, Msb 6.100, Houston, TX 77030 | 2017-10-18 |
| 1477924082 | Stephanie Wallace | Physician Assistant | 1625 N Campbell Ave, Tucson, AZ 85719-4330 | 2015-10-08 |
| 1477943223 | Stephanie Wallace | Pharmacist | 815 Cheyenne Meadows Rd, Colorado Springs, CO 80906-4929 | 2015-02-02 |
| 1033533617 | Stephanie Wallace | Counselor | 2001 W Blue Heron Blvd, Riviera Beach, FL 33404-5003 | 2014-02-18 |
| Street Address |
1212 HANCOCK ST STE 205 |
| City | QUINCY |
| State | MA |
| Zip Code | 02169-4371 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992053672 | Paula Moebus | Marriage & Family Therapist | 1212 Hancock St Ste 205, Quincy, MA 02169-4371 | 2012-08-28 |
| 1518591684 | Tina Huber | Marriage & Family Therapist | 1212 Hancock St Ste 205, Quincy, MA 02169-4371 | 2020-02-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902427933 | Trinasia Jones | Counselor | 80 Quarry Street, 3, Quincy, MA 02169 | 2020-04-30 |
| 1164060778 | Bid-milton Physician Associates Inc | Clinic/Center | 100 Walter J. Hannon Pkwy, Quincy, MA 02169 | 2019-12-13 |
| 1669028064 | Renee Yvette Belisle | Occupational Therapist | 1266 Furnance Brook Parkway, Suite #100b, Quincy, MA 02169 | 2019-08-13 |
| 1952953713 | Phuc Thi Diem Ho | Registered Nurse | 18 Rustic Place, Quincy, MA 02169 | 2019-07-11 |
| 1518451939 | Lucille Jordan | Social Worker | 1175 Sea St, Quincy, MA 02169 | 2018-06-19 |
| 1326567447 | Tara Barney | Counselor | 290 Quarry Street Apt. 112, Quincy, MA 02169 | 2017-09-11 |
| 1295251007 | Iona Dental, P.C. (parent Organization) | Dentist | 10 Granite Street, Unit - 4c, Quincy, MA 02169 | 2017-08-15 |
| 1730610247 | Amy S. Chung | Family Medicine | 100 Walter J. Hannon Parkway, Quincy, MA 02169 | 2017-03-26 |
| 1205377314 | Wing Man Ting | Counselor | 2 Moon Island Road, Quincy, MA 02169 | 2017-03-09 |
| 1740726223 | Cameron James Dumas | Pharmacist | 21 23 Stanhope Street, Boston, MA 02169 | 2017-01-09 |
| Find all providers in zip 02169 | ||||
| Taxonomy Code | 106H00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Marriage & Family Therapist |
| A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992053672 | Paula Moebus | Marriage & Family Therapist | 1212 Hancock St Ste 205, Quincy, MA 02169-4371 | 2012-08-28 |
| 1104112069 | Kathleen Marie Christenson Schwartz | Marriage & Family Therapist | 2056 E Main St, Suite #3, Quincy, CA 95971-9658 | 2011-06-20 |
| 1306981097 | Cassandra Mckinnon Cassias Campbell | Marriage & Family Therapist | 13 Temple St Fl 2, Quincy, MA 02169-5110 | 2007-02-20 |
| 1215091665 | Marjorie A. Gannon | Marriage & Family Therapist | 711 E. Main Street, Quincy, CA 95971 | 2006-12-20 |
| 1750466348 | County of Plumas | Marriage & Family Therapist | 270 County Hospital Rd, #109, Quincy, CA 95971-9126 | 2006-10-25 |
| 1215019476 | Michael Gunter | Marriage & Family Therapist | 372 Main St, Quincy, CA 95971 | 2006-10-19 |
| 1962483313 | Michael R Shanahan | Marriage & Family Therapist | 1354 Hancock St Ste 209, Quincy, MA 02169-5109 | 2005-11-10 |
| 1518591684 | Tina Huber | Marriage & Family Therapist | 1212 Hancock St Ste 205, Quincy, MA 02169-4371 | 2020-02-27 |
| 1003362369 | Amber Yannizzi | Marriage & Family Therapist | 23 E Elm Ave, Quincy, MA 02170-2905 | 2016-08-28 |
| 1083092860 | Plumas Rural Services | Marriage & Family Therapist | 711 E Main St, Quincy, CA 95971-9722 | 2015-05-12 |
| Find all providers in QUINCY | ||||
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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.