JENNIFER WALLACE (NPI# 1891166658) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891166658 |
| Entity Type | Individual |
| Full Name | JENNIFER WALLACE |
| Practice Address |
5965 S 900 E Salt Lake City UT 84121-1720 |
| Practice Telephone | 8012637138 |
| Mailing Telephone | 8012637138 |
| Enumeration Date | 2015-10-19 |
| Last Update Date | 2015-10-19 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101Y00000X | Counselor | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356968440 | Jennifer Wallace | Technician/Technologist | 2041 E 3rd Dr, Mesa, AZ 85204-1401 | 2020-07-06 |
| 1497249882 | Jennifer Laird Wallace | Licensed Practical Nurse | 4468 Duff Rd, Livingston, TX 77351-5627 | 2018-06-19 |
| 1124579602 | Jennifer Marie Wallace | Acupuncturist | 237 Avenida Del Norte, Redondo Beach, CA 90277-5702 | 2016-10-19 |
| 1174926984 | Jennifer Wallace | Specialist/Technologist | 806 Patton Chapel Trl, Hoover, AL 35226-2254 | 2014-10-07 |
| 1295083897 | Jennifer Wallace | Psychologist | 4226 Green Lake Rd, West Bloomfield, MI 48323-1139 | 2012-08-29 |
| 1669799086 | Jennifer Renea Wallace | Counselor | 3802 W University Blvd Apt 8104, Durant, OK 74701-3047 | 2010-04-24 |
| 1306035431 | Jennifer L Wallace | Physical Therapist | 3891 50th Ave S, Saint Petersburg, FL 33711-4811 | 2007-10-15 |
| 1316974058 | Jennifer Wallace | Speech-Language Pathologist | 1901 Century Blvd Ne Ste 20, Atlanta, GA 30345-3300 | 2006-06-27 |
| 1992766570 | Jennifer P Wallace | Specialist | 64400 E 26th Ct, Byers, CO 80103-8539 | 2006-03-31 |
| 1730154154 | Jennifer Lyn Wallace | Family Medicine | 1235 Se Division St, Suite 208, Portland, OR 97202-1099 | 2006-02-20 |
| Street Address |
5965 S 900 E |
| City | SALT LAKE CITY |
| State | UT |
| Zip Code | 84121-1720 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497745301 | Debra Lynn Falvo | Registered Nurse | 5965 S 900 E, Salt Lake City, UT 84121-1720 | 2005-10-24 |
| 1376908087 | Alyssa Milne | Counselor | 5965 S 900 E, Salt Lake City, UT 84121-1720 | 2015-12-22 |
| 1053776138 | Rachel Feinberg | Counselor | 5965 S 900 E, Salt Lake City, UT 84121-1720 | 2015-12-16 |
| 1174997894 | April Madsen | Counselor | 5965 S 900 E, Salt Lake City, UT 84121-1720 | 2015-11-18 |
| 1639542608 | Lauren Carah Christensen | Counselor | 5965 S 900 E, Salt Lake City, UT 84121-1720 | 2015-11-12 |
| 1154794725 | Claire Nitz | Counselor | 5965 S 900 E, Salt Lake City, UT 84121-1720 | 2015-11-04 |
| 1063884427 | Jannah Lee Faumuina | Social Worker | 5965 S 900 E, Salt Lake City, UT 84121-1720 | 2015-10-26 |
| 1215309901 | Joni Whitaker | Counselor | 5965 S 900 E, Salt Lake City, UT 84121-1720 | 2015-10-21 |
| 1295107076 | Anisa Plastow | Social Worker | 5965 S 900 E, Salt Lake City, UT 84121-1720 | 2015-10-20 |
| 1013387315 | Kimberly Randolph | Registered Nurse | 5965 S 900 E, Salt Lake City, UT 84121-1720 | 2015-09-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407483522 | Kaitlyn Horne | Behavior Technician | 6910 S. Highland Drive, Cottonwood Heights, UT 84121 | 2020-03-26 |
| 1952936387 | Jared Wells | Behavior Technician | 6910 S Highland Drive, Cottonwood Heights, UT 84121 | 2020-03-05 |
| 1518591874 | Slc Plastic Surgery LLC | Plastic Surgery | 6686 Highland Drive, Cottonwood Heights, UT 84121 | 2020-02-26 |
| 1093273708 | Anna O'hearon | Counselor | New Roads Behavioral Health, 2450 Fort Union Blvd, Cottonwood Heights, UT 84121 | 2019-03-12 |
| 1053883181 | Charles Keller IIi | Pediatrics | 2198 S Yvonne Rd #344, Salt Lake City, UT 84121 | 2018-12-31 |
| 1669964516 | Marissa King | Specialist | 1141 E. 3900 S. Suite 150a, Salt Lake, UT 84121 | 2018-06-05 |
| 1376044313 | Slpd Cottonwood LLC | Dentist | 7167 South Highland Drive, 200, Cottonwood Heights, UT 84121 | 2018-02-26 |
| 1700315462 | Nelson & Tillmann Family Dentistry, PC | Dentist | 5872 S. 900 E. Ste 202, Salt Lake City, UT 84121 | 2017-06-07 |
| 1912430588 | Wasatch Midwifery and Wellness, LLC | Dietitian, Registered | 6440 S Wasatch Blvd, Ste 140, Holladay, UT 84121 | 2017-04-10 |
| 1407308331 | Tina Polgar | Registered Nurse | 6244 Highland Drive, Murray, UT 84121 | 2016-10-26 |
| Find all providers in zip 84121 | ||||
| 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 |
|---|---|---|---|---|
| 1780281519 | Sitti Suhardi | Counselor | 2550 S Main St Apt 1307, Salt Lake City, UT 84115-3071 | 2020-10-05 |
| 1801400015 | Tyra Mae Vance | Counselor | 3375 S 880 E, Salt Lake City, UT 84106 | 2020-09-04 |
| 1033721394 | Salt Lake Therapy Collective | Counselor | 311 S 900 E Ste 103, Salt Lake City, UT 84102-2491 | 2020-08-18 |
| 1083172704 | Brooke Pyper | Counselor | 335 W Bugatti Dr, Salt Lake City, UT 84115-2521 | 2019-03-12 |
| 1881168185 | Korilynn Cheatham Bartley | Counselor | 124 S 400 E Ste 300, Salt Lake City, UT 84111-5307 | 2019-01-20 |
| 1164910089 | Gerald Louis Costley | Counselor | 339 E 3900 S Ste 155, Salt Lake City, UT 84107-1978 | 2018-04-26 |
| 1912412867 | Jackson Patrick Collins | Counselor | 1650 E 6670 S, Salt Lake City, UT 84121-2760 | 2017-12-13 |
| 1891225678 | Phil Edward Francis | Counselor | 4000 S 700 E Ste 9, Salt Lake City, UT 84107-2581 | 2017-06-14 |
| 1063866549 | Dustin Palmer | Counselor | 344 E 100 S # 230, Salt Lake City, UT 84111 | 2016-04-20 |
| 1740642735 | Misty Tae Ungricht | Counselor | 4460 S Highland Dr Ste 2106b, Salt Lake City, UT 84124-3543 | 2016-03-28 |
| Find all providers in SALT LAKE CITY | ||||
| City | SALT LAKE CITY |
| Zip Code | 84121 |
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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.