MR. DUANE ANTHONY WALLACE (NPI# 1932434974) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932434974 |
| Entity Type | Individual |
| Full Name | MR. DUANE ANTHONY WALLACE |
| Credential | CSAC |
| Practice Address |
1 W Geneva St Credence Therapy Associates Elkhorn WI 53121-1722 |
| Mailing Address |
1 W Geneva St Elkhorn WI 53121-1722 |
| Practice Telephone | 2627233424 |
| Mailing Telephone | 2627233424 |
| Enumeration Date | 2009-10-08 |
| Last Update Date | 2013-07-31 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932443132 | Duane Isabel Wallace | Counselor | 151 Bent Ridge Dr S, Dawsonville, GA 30534-3337 | 2012-11-12 |
| 1437328713 | Duane Leo Wallace | Dentist | 63 Geiger Road, Rome, NY 13441 | 2008-02-21 |
| 1679730378 | Duane Wallace | Pharmacist | 665 3rd St Sw, Perham, MN 56573-1137 | 2008-05-20 |
| Street Address |
1 W GENEVA ST CREDENCE THERAPY ASSOCIATES |
| City | ELKHORN |
| State | WI |
| Zip Code | 53121-1722 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437401874 | Cheryl Brost | Counselor | 1 W Geneva St, Elkhorn, WI 53121-1722 | 2012-10-09 |
| 1346534591 | Kimberly Leskovar | Counselor | 1 W Geneva St, Elkhorn, WI 53121-1722 | 2011-06-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851857601 | All Encompassing Counseling LLC | Clinic/Center | 209 O'connor Drive, Elkhorn, WI 53121 | 2019-02-18 |
| 1689023848 | Jill Bestul | Occupational Therapist | 1532 N. Fairway Lane, Elkhorn, WI 53121 | 2016-06-08 |
| 1578984571 | Aurora Pharmacy Inc. | Pharmacy | 201 E. Morrissey Dr, Suite 100, Elkhorn, WI 53121 | 2013-12-18 |
| 1467894394 | Stephanie Lynn Coates | Counselor | 1 1/2 West Geneva Street, Credence Therapy Associates, Elkhorn, WI 53121 | 2013-07-19 |
| 1871853846 | Roger Dwight Petersen | Family Medicine | 20 South Washington St, Elkhorn, WI 53121 | 2012-05-23 |
| 1184993792 | Adam D Lewis | Pharmacist | 939 N. Wisconsin St., Elkhorn, WI 53121 | 2011-12-28 |
| 1609035328 | Paul V Kreul | Dentist | 715 W Walworth St, Elkhorn, WI 53121 | 2008-06-06 |
| 1548482508 | Mary Brauer | Physical Therapist | W3930 Co Rd Nn, Elkhorn, WI 53121 | 2007-05-02 |
| 1245458140 | Tammie Eileen Demicco | Occupational Therapy Assistant | 1922 County Rd. Nn, Elkhorn, WI 53121 | 2007-04-23 |
| 1215150198 | Laura L Barnes | Physical Therapy Assistant | 1922 County Road Nn, Elkhorn, WI 53121 | 2007-04-10 |
| Find all providers in zip 53121 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528577277 | Marinna Mil Marotta | Counselor | 209 Oconnor Dr, Elkhorn, WI 53121-4269 | 2017-09-26 |
| 1467894394 | Stephanie Lynn Coates | Counselor | 1 1/2 West Geneva Street, Credence Therapy Associates, Elkhorn, WI 53121 | 2013-07-19 |
| 1275763450 | Victoria Elizabeth Stegall | Counselor | 1045 S 217th St, Elkhorn, NE 68022-1933 | 2009-07-21 |
| 1144716150 | Paige Vorderstrasse | Counselor | 20275 Honeysuckle Dr Ste 103, Elkhorn, NE 68022-3962 | 2018-07-03 |
| 1093198335 | Catherine Griffith | Counselor | W4051 County Road Nn, Elkhorn, WI 53121-4338 | 2015-07-06 |
| 1164767059 | Malinda Beth Aney | Counselor | W4051 County Road Nn, Elkhorn, WI 53121-4338 | 2012-12-03 |
| 1619211497 | Heidi S Wood | Counselor | W4051 County Road Nn, Elkhorn, WI 53121-4338 | 2012-11-19 |
| 1073879201 | Michelle Schrubbe | Counselor | W4051 County Road Nn, Elkhorn, WI 53121-4338 | 2012-04-02 |
| 1528381431 | Joyce Placzkowski | Counselor | 797 E Geneva St, Elkhorn, WI 53121-2303 | 2010-03-05 |
| 1235366683 | Bridget S Lee | Counselor | W4051 County Rd Nn, Elkhorn, WI 53121 | 2009-06-12 |
| Find all providers in ELKHORN | ||||
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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.