ALEX WALLACE (NPI# 1437637592) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1437637592 |
| Entity Type | Individual |
| Full Name | ALEX WALLACE |
| Credential | MA. LMHCA |
| Practice Address |
1411 Lincolnway W Mishawaka IN 46544-1626 |
| Mailing Address |
330 Lakeview Dr Goshen IN 46528-7000 |
| Practice Telephone | 5745331234 |
| Practice Fax Number | 5745372652 |
| Mailing Telephone | 5745331234 |
| Mailing Fax Number | 5745372652 |
| Enumeration Date | 2018-08-01 |
| Last Update Date | 2018-08-01 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101Y00000X | Counselor | 88000618A | IN | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841290855 | Alex J Wallace | Pharmacist | 530 Spruce Lane, Lisle, IL 60532-4370 | 2005-08-01 |
| 1316334675 | Alex Wallace | Radiology | 13400 E Shea Blvd, Scottsdale, AZ 85259-5452 | 2015-04-23 |
| Street Address |
1411 LINCOLNWAY W |
| City | MISHAWAKA |
| State | IN |
| Zip Code | 46544-1626 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770571697 | Rita M Mitcheff | Social Worker | 1411 Lincolnway W, Mishawaka, IN 46544-1626 | 2005-10-13 |
| 1750980579 | Kaylyn Bussard | Counselor | 1411 Lincolnway W, Mishawaka, IN 46544-1626 | 2020-10-22 |
| 1316577711 | Robert Sepulveda | Counselor | 1411 Lincolnway W, Mishawaka, IN 46544-1626 | 2020-01-24 |
| 1790329068 | Farah A Ali | Counselor | 1411 Lincolnway W, Mishawaka, IN 46544-1626 | 2019-10-30 |
| 1023676954 | Carolyn Logue | Counselor | 1411 Lincolnway W, Mishawaka, IN 46544-1626 | 2019-06-05 |
| 1861956955 | Zerina Cardaklija | Counselor | 1411 Lincolnway W, Mishawaka, IN 46544-1626 | 2019-01-23 |
| 1851869309 | Chelsey Luke | Counselor | 1411 Lincolnway W, Mishawaka, IN 46544-1626 | 2018-11-02 |
| 1073095121 | Diana Bakia | Counselor | 1411 Lincolnway W, Mishawaka, IN 46544-1626 | 2018-09-05 |
| 1245719558 | Elizabeth Loveland | Counselor | 1411 Lincolnway W, Mishawaka, IN 46544-1626 | 2018-08-08 |
| 1952893885 | Elizabeth Miller | Social Worker | 1411 Lincolnway W, Mishawaka, IN 46544 | 2018-06-06 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720692676 | Lynnette Markowicz | Occupational Therapist | 1540 S. Logan St, Mishawaka, IN 46544 | 2020-09-08 |
| 1902429822 | Hellenic Senior Living of Mishawaka LLC | Assisted Living Facility | 1540 S. Logan Street, Mishawaka, IN 46544 | 2020-05-27 |
| 1184275422 | Lorrajean A Gleva | Technician | 203 Eastgate Circle, Mishawaka, IN 46544 | 2019-09-27 |
| 1376072785 | Aims, LLC | Psychologist | 1113 Mossy Lane, Mishawaka, IN 46544 | 2017-06-08 |
| 1760835912 | Ophelia Ansari | Nurse Practitioner | 4501 Linconway East, Mishawaka, IN 46544 | 2016-07-22 |
| 1598153355 | Hearing Aid Service | Hearing Instrument Specialist | 3718 Lincolnway E, Mishawaka, IN 46544 | 2015-01-02 |
| 1437587953 | Christopher Ryan Hazel | Dentist | 544 Lincolnway West, Mishawaka, IN 46544 | 2013-10-18 |
| 1699015941 | Frank Walerko | Urology | 809 Bittersweet Cove Drive, Mishawaka, IN 46544 | 2013-02-25 |
| 1023251337 | Josephine Schimizzi | Family Medicine | 1505 South Spring Street, Mishawaka, IN 46544 | 2009-04-16 |
| 1881831147 | Walgreen Co | Pharmacy | 4620 Lincolnway E, Mishawaka, IN 46544 | 2009-01-08 |
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| Taxonomy Code | 101Y00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master’s degree and clinical experience and supervision for licensure or certification. |
| Notes: Sources: Abridged from definitions provided by the National Board of Certified Counselors and the American Association of Pastoral Counselors. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124574462 | Monica A Murphy | Counselor | 1818 Went Ave., Suite A, Mishawaka, IN 46545-6482 | 2016-08-28 |
| 1285933812 | Kimberly D Delcourt | Counselor | 509 W Mckinley Ave, Ste 3, Mishawaka, IN 46545-5564 | 2011-03-22 |
| 1083788426 | Lincoln Counseling, PC | Counselor | 113 Lincoln Way E, Mishawaka, IN 46544-2016 | 2006-11-18 |
| 1750980579 | Kaylyn Bussard | Counselor | 1411 Lincolnway W, Mishawaka, IN 46544-1626 | 2020-10-22 |
| 1962030882 | Erica Holdren | Counselor | 1818 Went Ave Ste A, Mishawaka, IN 46545-6482 | 2020-03-27 |
| 1316577711 | Robert Sepulveda | Counselor | 1411 Lincolnway W, Mishawaka, IN 46544-1626 | 2020-01-24 |
| 1790329068 | Farah A Ali | Counselor | 1411 Lincolnway W, Mishawaka, IN 46544-1626 | 2019-10-30 |
| 1023676954 | Carolyn Logue | Counselor | 1411 Lincolnway W, Mishawaka, IN 46544-1626 | 2019-06-05 |
| 1861956955 | Zerina Cardaklija | Counselor | 1411 Lincolnway W, Mishawaka, IN 46544-1626 | 2019-01-23 |
| 1851869309 | Chelsey Luke | Counselor | 1411 Lincolnway W, Mishawaka, IN 46544-1626 | 2018-11-02 |
| Find all providers in MISHAWAKA | ||||
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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.