SUSAN LEE WALLACE (NPI# 1972719938) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972719938 |
| Entity Type | Individual |
| Full Name | SUSAN LEE WALLACE |
| Credential | LCSW |
| Practice Address |
947 El Dorado Ave Santa Cruz CA 95062-2863 |
| Practice Telephone | 8314797195 |
| Mailing Telephone | 8314797195 |
| Enumeration Date | 2007-05-15 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
15024 | CA | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477910792 | Susan Anne Wallace | Licensed Practical Nurse | 44 Beechwood Dr, Manorville, NY 11949-2947 | 2016-01-16 |
| 1376842732 | Susan Elizabeth Wallace | Dietitian, Registered | 102 Carran Dr, Lakeside Park, KY 41017-2233 | 2011-03-23 |
| 1598904427 | Susan Leigh Wallace | Specialist | 103 Windwood Rd, North Syracuse, NY 13212-1956 | 2009-02-17 |
| 1366646457 | Susan Taylor Wallace | Speech-Language Pathologist | 3409 Connection Dr, Fayetteville, NC 28311-0151 | 2007-06-12 |
| 1952426025 | Susan Wallace | Acupuncturist | 1009 Solano Ave, # A, Albany, CA 94706-1617 | 2007-03-20 |
| 1447375662 | Susan D. Wallace | Counselor | 166 Pawtucket Avenue, Pawtucket, RI 02860-3811 | 2007-03-20 |
| 1639554769 | Susan Wallace | Physical Therapist | 35 Medical Center Pkwy, Augusta, ME 04330-8160 | 2015-07-30 |
| 1740537687 | Susan R Wallace | Nurse Practitioner | 100 Methodist Blvd, Hattiesburg, MS 39402-1295 | 2012-08-09 |
| 1710247812 | Susan Victoria Wallace | Marriage & Family Therapist | 9685 Hayes St, Riverside, CA 92503-3660 | 2012-05-22 |
| 1427203462 | Susan Marie Wallace | Occupational Therapist | 355 Oak Grove Rd, Spartanburg, SC 29301-2537 | 2008-11-18 |
| Street Address |
947 EL DORADO AVE |
| City | SANTA CRUZ |
| State | CA |
| Zip Code | 95062-2863 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760698633 | Elizabeth Marie Dailey | Counselor | 947 El Dorado Ave, Santa Cruz, CA 95062-2863 | 2007-05-15 |
| 1497078273 | Encompass Community Services | Community/Behavioral Health | 947 El Dorado Ave, Santa Cruz, CA 95062-2863 | 2010-03-08 |
| 1649475898 | Jane Marie Warren | Counselor | 947 El Dorado Ave, Santa Cruz, CA 95062-2863 | 2007-06-18 |
| 1023228574 | El Dorado Center Partial Hospitalization | Psychiatric Unit | 947 El Dorado Ave, Santa Cruz, CA 95062-2863 | 2007-05-23 |
| 1043429681 | Danielle Hunter | Marriage & Family Therapist | 947 El Dorado Ave, Santa Cruz, CA 95062-2863 | 2007-05-21 |
| 1427264399 | John Robert Mulvey | Social Worker | 947 El Dorado Ave, Santa Cruz, CA 95062-2863 | 2007-05-15 |
| 1891901773 | Dennis Lee Akin | Counselor | 947 El Dorado Ave, Santa Cruz, CA 95062-2863 | 2007-05-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730706698 | Laura Lynn Rabb-jancola | Home Health | 275 Lake Ave #8, Santa Cruz, CA 95062 | 2020-06-26 |
| 1043792740 | New Life Community Services, Inc | Substance Abuse Rehabilitation Facility | 521 Capitola Rd Ext, Santa Cruz, CA 95062 | 2018-08-30 |
| 1780180380 | Philips Patton | Acupuncturist | 129 Dake Ave, Santa Cruz, CA 95062 | 2018-04-03 |
| 1477069896 | Wei Jiang | Acupuncturist | 1099 38th Ave #46, Santa Cruz, CA 95062 | 2017-12-21 |
| 1336679885 | Camm Nelsen | Counselor | 200 7th Avenue. Suite 150, Santa Cruz, CA 95062 | 2017-06-18 |
| 1639601784 | Catharine Lee Sheets | Registered Nurse | 21507 East Cliff Drive, Santa Cruz, CA 95062 | 2017-03-29 |
| 1972968857 | Brenda M. Williams | Counselor | 941 Eldorado Ave, Santa Cruz, CA 95062 | 2015-12-21 |
| 1124490347 | Emily Fittante | Social Worker | 343 Soquel Ave #195, Santa Cruz, CA 95062 | 2015-10-27 |
| 1578935839 | Jennifer Langon, Lmft | Community/Behavioral Health | 5905 Soquel Ave Suite 400, Aptos, CA 95062 | 2015-10-27 |
| 1255718581 | Joanne Gramo | Acupuncturist | 316a Oceanview Ave., Santa Cruz, CA 95062 | 2015-05-06 |
| Find all providers in zip 95062 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023621067 | Adiari Torres | Social Worker | 402 Dakota Ave Apt 8, Santa Cruz, CA 95060-4122 | 2020-08-28 |
| 1487273645 | Victoria Jeanne Dzorka | Social Worker | 125 Water St Ste A2, Santa Cruz, CA 95060-2786 | 2020-04-08 |
| 1245876002 | Steven C Weiss | Social Worker | 1740 17th Ave, Santa Cruz, CA 95062-1804 | 2019-11-26 |
| 1528610581 | Melanie Jayne Stern | Social Worker | 429 Continental St, Santa Cruz, CA 95060-6070 | 2019-07-10 |
| 1902466469 | Neil David Brown | Social Worker | 550 Water St Ste D2, Santa Cruz, CA 95060-4129 | 2019-06-17 |
| 1659851525 | Vincent J Oviedo | Social Worker | 103 Auburn Ave, Santa Cruz, CA 95060-6231 | 2018-08-20 |
| 1124490347 | Emily Fittante | Social Worker | 343 Soquel Ave #195, Santa Cruz, CA 95062 | 2015-10-27 |
| 1952788861 | Jodi Mulder | Social Worker | 903 Pacific Ave Ste 200, Santa Cruz, CA 95060-4461 | 2015-04-29 |
| 1073903050 | Christina O'halloran | Social Worker | 143 Stockton Ave, Santa Cruz, CA 95060-6219 | 2015-01-29 |
| 1972900538 | Katrina Tattenham | Social Worker | 1200 Capitola Rd Apt 21, Santa Cruz, CA 95062-2945 | 2014-11-25 |
| Find all providers in SANTA CRUZ | ||||
| City | SANTA CRUZ |
| Zip Code | 95062 |
Please comment or provide details below to improve the information on SUSAN LEE 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.