MRS. CONNIE L. WALLACE (NPI# 1821181603) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821181603 |
| Entity Type | Individual |
| Full Name | MRS. CONNIE L. WALLACE |
| Credential | MA, LPCC |
| Practice Address |
6435 E Broad St Columbus OH 43213-1507 |
| Mailing Address |
Dept 781625 P.o. Box 78000 Detroit MI 48278-1625 |
| Practice Telephone | 6143558160 |
| Practice Fax Number | 6143558180 |
| Mailing Telephone | 6143558004 |
| Mailing Fax Number | 6143552220 |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2020-07-15 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YM0800X |
Counselor Specialization: Mental Health |
E-0004373 | OH | Behavioral Health & Social Service Providers |
| Y | 101YP2500X |
Counselor Specialization: Professional |
E0004373 | OH | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | 1473276 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851592711 | Connie S. Wallace | Speech-Language Pathologist | 10063 Irish Way, Union, KY 41091-7103 | 2007-05-29 |
| 1861588071 | Connie J Wallace | Counselor | 1412 17th St # 352, Bakersfield, CA 93301-5211 | 2006-10-05 |
| 1386668200 | Connie Lee Wallace | Counselor | 547 1/2 S James St, Ste. A, Dover, OH 44622-2137 | 2006-07-26 |
| 1619179132 | Connie Sue Wallace | Physician Assistant | 125 Baldwin Ave Ste 200, Charlotte, NC 28204-3370 | 2007-06-05 |
| Street Address |
6435 E BROAD ST |
| City | COLUMBUS |
| State | OH |
| Zip Code | 43213-1507 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922024074 | Joseph R Rogers | Counselor | 6435 E Broad St, Columbus, OH 43213-1507 | 2006-07-14 |
| 1326527748 | Bansari Thakkar | Social Worker | 6435 E Broad St, Columbus, OH 43213-1507 | 2018-08-07 |
| 1356845143 | Davina Carolyn Adams-jackson | Marriage & Family Therapist | 6435 E Broad St, Columbus, OH 43213-1507 | 2018-03-19 |
| 1700397791 | William J Leever | Psychologist | 6435 E Broad St, Columbus, OH 43213-1507 | 2017-10-17 |
| 1881103513 | Shonda Montroy | Social Worker | 6435 E Broad St, Columbus, OH 43213-1507 | 2017-09-26 |
| 1942725809 | Paige Amber Williams | Social Worker | 6435 E Broad St, Columbus, OH 43213-1507 | 2017-08-11 |
| 1821524687 | Emily Darlington | Social Worker | 6435 E Broad St, Columbus, OH 43213 | 2017-05-11 |
| 1437698040 | Tabatha Sapene | Social Worker | 6435 E Broad St, Columbus, OH 43213-1507 | 2017-02-15 |
| 1992165492 | Margaret Murdock | Social Worker | 6435 E Broad St, Columbus, OH 43213-1507 | 2016-02-26 |
| 1730548611 | Shannon Crather | Counselor | 6435 E Broad St, Columbus, OH 43213-1507 | 2016-02-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952917973 | Complete Care for Women | Obstetrics & Gynecology | 99 North Brice Rd, Suite 320, Columbus, OH 43213 | 2020-09-16 |
| 1255963708 | Icare Health & Wellness Medical Center, LLC | Counselor | 3242 E Main St, 2nd Floor, Columbus, OH 43213 | 2020-02-12 |
| 1588133011 | Robert Acheampong-imbeah | Case Manager/Care Coordinator | 3616 Eastwood Park, Whitehall, OH 43213 | 2018-11-14 |
| 1174017248 | Faatimah Sabir | Case Manager/Care Coordinator | 3616 East Main Street, Whitehall, OH 43213 | 2018-06-21 |
| 1639663123 | Reachcare Pharmacy Services LLC | Pharmacy | 4513 E Main St, Columbus, OH 43213 | 2018-06-18 |
| 1245729516 | Dominique Oswalt | Case Manager/Care Coordinator | 4111 Elbern Ave, Whitehall, OH 43213 | 2018-05-02 |
| 1326540865 | Jmkennedy LLC Magnum Np | Nursing Care | 6365 Plankton Dr, Columbus, OH 43213 | 2018-03-01 |
| 1477051647 | Inner Health Chiropractic North, LLC | Chiropractor | Inner Health Chiropractic, 3321 East Broad Street, Columbus, OH 43213 | 2018-01-23 |
| 1902319213 | Mary H Taylor | Massage Therapist | 6100 E. Main St., Suite 110, Columbus, OH 43213 | 2017-11-08 |
| 1407384548 | Lashaunta R Davidson | Licensed Practical Nurse | 4040 E. Broad Street, Whitehall, OH 43213 | 2017-06-02 |
| Find all providers in zip 43213 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609481233 | Dupe Esther Oluwamuyide | Counselor | 1558 Sargas St, Columbus, OH 43240-6071 | 2020-09-10 |
| 1346851086 | Jeannine Marie Lumpkin | Counselor | 5065 Pond View Dr, Columbus, GA 31907-1887 | 2020-08-16 |
| 1174141543 | Emanuel G Werner | Counselor | 4033 Legend, Columbus, OH 43230-8501 | 2020-07-11 |
| 1285256552 | Lauren Elizabeth Singleton | Counselor | 5632 Winvelly Dr, Columbus, GA 31909-4777 | 2020-05-10 |
| 1265053268 | Bradley Unruh | Counselor | 1290 Old Henderson Rd, Columbus, OH 43220-3608 | 2020-04-30 |
| 1073153904 | Overbrook Counseling LLC | Counselor | 1161 Bethel Rd Ofc 5, Columbus, OH 43220-2773 | 2020-01-08 |
| 1871137497 | Tammy Dionne Person | Counselor | 6718 Bridge Way, Columbus, GA 31904-1370 | 2019-11-06 |
| 1740836659 | Allen Huff | Counselor | 223 Mayfair Blvd Apt D, Columbus, OH 43213-2212 | 2019-08-15 |
| 1780236224 | Emilie Rae Rogers | Counselor | 94 Northwoods Blvd Ste B2, Columbus, OH 43235-4721 | 2019-07-15 |
| 1649834441 | Stacey R Young | Counselor | 1620 E Broad St Ste 103, Columbus, OH 43203-2012 | 2019-04-26 |
| Find all providers in COLUMBUS | ||||
Please comment or provide details below to improve the information on MRS. CONNIE L. WALLACE.
| 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.