MRS. ANGELA M WALLACE (NPI# 1750884631) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750884631 |
| Entity Type | Individual |
| Full Name | MRS. ANGELA M WALLACE |
| Credential | LLPC |
| Practice Address |
400 Stoddard Rd Richmond MI 48062-2505 |
| Practice Telephone | 8103922167 |
| Mailing Telephone | 8103922167 |
| Enumeration Date | 2018-03-16 |
| Last Update Date | 2018-03-17 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
6401016486 | MI | Behavioral Health & Social Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 400 Stoddard Rd, Richmond, MI 480622505 | 8108585161 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073584652 | Angela M Wallace | Nurse Practitioner | 9300 Dewitt Loop Dept Of, Ft Belvoir, VA 22060-5285 | 2006-01-31 |
| 1417435819 | Angela Wallace | Counselor | 11222 Tesson Ferry Rd Ste 100, Saint Louis, MO 63123-6963 | 2018-07-30 |
| 1417452731 | Angela Kathleen Wallace | Marriage & Family Therapist | 554 S San Vicente Blvd Ste 200, Los Angeles, CA 90048-4651 | 2018-03-28 |
| 1114204450 | Angela D Wallace | Counselor | 101 N Union Ave, Shawnee, OK 74801-7067 | 2011-11-15 |
| 1255510848 | Angela Darlene Wallace | Anesthesiology | 36000 Darnall Loop, Fort Hood, TX 76544-5095 | 2007-10-31 |
| 1295849081 | Angela D. Wallace | Day Training/Habilitation Specialist | 140 Hospital Dr, South Williamson, KY 41503-4022 | 2006-08-18 |
| Street Address |
400 STODDARD RD |
| City | RICHMOND |
| State | MI |
| Zip Code | 48062-2505 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750363305 | Sacred Heart Rehabilitation Center, Inc. | Community/Behavioral Health | 400 Stoddard Rd, Richmond, MI 48062-2505 | 2005-11-18 |
| 1164023578 | Christopher Doan | Peer Specialist | 400 Stoddard Rd, Richmond, MI 48062-2505 | 2020-11-03 |
| 1881292316 | Melissa C Glasson | Social Worker | 400 Stoddard Rd, Richmond, MI 48062-2505 | 2020-10-16 |
| 1861090540 | Theresa Dilaura Strongarone | Counselor | 400 Stoddard Rd, Richmond, MI 48062-2505 | 2020-10-14 |
| 1629684915 | Adam C Keller | Peer Specialist | 400 Stoddard Rd, Richmond, MI 48062-2505 | 2020-09-22 |
| 1215546304 | James A Johns | Counselor | 400 Stoddard Rd, Richmond, MI 48062-2505 | 2020-07-24 |
| 1700403870 | Madeline Burke | Counselor | 400 Stoddard Rd, Richmond, MI 48062-2505 | 2020-07-06 |
| 1083231302 | Jennifer Eve-lyn Hoffer | Counselor | 400 Stoddard Rd, Richmond, MI 48062-2505 | 2020-07-02 |
| 1134745201 | Chelsey Dianne Elizabeth Carrow | Counselor | 400 Stoddard Rd, Richmond, MI 48062-2505 | 2020-06-24 |
| 1508496431 | Alexis Nina Monaco | Counselor | 400 Stoddard Rd, Richmond, MI 48062-2505 | 2020-01-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184110645 | Lisa Marie Pollauf | Occupational Therapist | 5383 Hessen Rd, Casco, MI 48062 | 2018-07-09 |
| 1073010211 | Alaina Miron | Physical Therapist | Medilodge of Richmond 34901 Division, Richmond, MI 48062 | 2018-04-12 |
| 1841450988 | Thomas Anthony Campbell-cormier | Dentist | 35035 Helze Ln, Richmond Township, MI 48062 | 2008-06-12 |
| 1649438797 | Richmond Physical Therapy Inc | Physical Therapist | 67505 Main Street, Richmond, MI 48062 | 2008-05-27 |
| 1295941391 | John Francis King | Social Worker | 35000 Division, Suite 2, Richmond, MI 48062 | 2007-05-15 |
| 1104963677 | Frank J. Markie | Dentist | 36600 Heritage Dr, Richmond, MI 48062 | 2007-01-31 |
| 1033256508 | Brian J. Pradko | Dentist | 36600 Heritage Dr., Richmond, MI 48062 | 2007-01-31 |
| 1336286897 | Pradko, Gallagher & Slance, Pllc | Dentist | 36600 Heritage Drive, Richmond, MI 48062 | 2007-01-31 |
| 1538215967 | Kenneth Edward Niemi | Dentist | 68720 Main St, Richmond, MI 48062 | 2007-01-26 |
| 1295824068 | Richmond Lenox Ems Ambulance Authority | Public Health or Welfare | 34505 32 Mile Road, Richmond, MI 48062 | 2006-10-12 |
| Find all providers in zip 48062 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225640790 | Cindy Beardsley | Counselor | 3414 Solano Ave, Richmond, CA 94805-1745 | 2020-08-17 |
| 1972114585 | Lynn Nicole Thompson | Counselor | 1621 Foxhaven Dr, Richmond, KY 40475-1056 | 2020-08-17 |
| 1346867058 | Kristin Fitzgerald | Counselor | 2320 Broad Rock Blvd, Richmond, VA 23224-4812 | 2020-06-29 |
| 1891317269 | Padme Wellness, LLC | Counselor | 704 N 1st St, Richmond, VA 23219-1310 | 2020-05-08 |
| 1548891740 | Jeanne Evelyn Pizzagrani I | Counselor | 2355 Lancaster Dr Apt 7, Richmond, CA 94806-3046 | 2020-01-28 |
| 1518445204 | Crystal Lester-lewis | Counselor | 4325 Mylan Rd, Richmond, VA 23223-2273 | 2018-08-03 |
| 1972098416 | Rachelle Raquel Valenzuela | Counselor | 666 38th St, Richmond, CA 94805-1702 | 2018-06-27 |
| 1144724964 | Natalie Orme Waters | Counselor | 681 Hioaks Rd Ste C&j, Richmond, VA 23225-4043 | 2018-03-19 |
| 1669974358 | Kisha Monique Jones | Counselor | 208 23rd St, Richmond, CA 94804-1830 | 2018-03-08 |
| 1659889723 | Karon Harris | Counselor | 9609 Jefferson Davis Highway, Richmond, VA 23237 | 2018-01-11 |
| Find all providers in RICHMOND | ||||
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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.