JILL WALLACE (NPI# 1992029664) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992029664 |
| Entity Type | Individual |
| Full Name | JILL WALLACE |
| Credential | M.ED,LCPC |
| Practice Address |
56 Elm St Topsham ME 04086-1417 |
| Practice Telephone | 2074495729 |
| Practice Fax Number | 8665318540 |
| Enumeration Date | 2010-03-24 |
| Last Update Date | 2010-03-24 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YP2500X |
Counselor Specialization: Professional |
CC00000733 | ME | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598121220 | Jill Marie Wallace | Nurse Practitioner | 16406 Birchley Cir, Charlotte, NC 28213-4314 | 2016-01-11 |
| 1902985724 | Jill Natalie Wallace | Social Worker | 51 Kendrick Ln, Dix Hills, NY 11746-7849 | 2006-11-03 |
| 1104883099 | Jill Wallace | Physical Therapist | W239n1812 Rockwood Dr Ste 100, Phcma Inc., Waukesha, WI 53188-1113 | 2006-04-26 |
| Street Address |
56 ELM ST |
| City | TOPSHAM |
| State | ME |
| Zip Code | 04086-1417 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699387522 | Sra Healthcare, LLC | Assisted Living Facility | 56 Elm St, Topsham, ME 04086-1417 | 2020-08-21 |
| 1588205090 | Alaimo Health Partners LLC | Custodial Care Facility | 56 Elm St, Topsham, ME 04086-1417 | 2019-10-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770196040 | Martha Densmore | Registered Nurse | 49 Topsham Fair Mall Rd., Topsham, ME 04086 | 2020-08-26 |
| 1972156727 | Wanho Lew | Dentist | 127 Topsham Fail Mall Rd., Topsham, ME 04086 | 2019-07-22 |
| 1326510595 | Apex Residential Support Services LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 196 Meadow Cross Rd, Topsham, ME 04086 | 2018-12-27 |
| 1891143681 | Kai N Cheng | Physician Assistant | 105 Topsham Fair Mall Rd Ste 8, Topsham, ME 04086 | 2016-06-02 |
| 1487028775 | Reform Physical Therapy, Inc | Physical Therapist | 439 Lewiston Rd, Topsham, ME 04086 | 2015-11-24 |
| 1457773301 | Kelly Fritz | Physical Therapist | 126 Main St Ste 3, Topsham, ME 04086 | 2014-01-13 |
| 1831493964 | Diane Lamere-wallace | Occupational Therapist | 19 Perkins Avenue, Topsham, ME 04086 | 2011-01-04 |
| 1376702597 | Julia Sullivan Cabral | Social Worker | 63 Elm Street, Ste B, Topsham, ME 04086 | 2008-06-03 |
| 1285830554 | Brian Roger Haney | Internal Medicine | 105 Topsham Fair Mall Rd Unit 1, Topsham, ME 04086 | 2007-06-25 |
| 1003917501 | Nancy A Porr | Nurse Practitioner | 4 Horton Place, Suite 101, Topsham, ME 04086 | 2006-09-26 |
| Find all providers in zip 04086 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447239009 | Elizabeth Boyajian | Counselor | 63 E Elm Street, Feldspar Mill, Topsham, ME 04086 | 2006-01-12 |
| 1063627826 | Thomas C Babbitt II | Counselor | 10 Pleasant St, Topsham, ME 04086-1410 | 2007-05-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568062271 | Megan Joanne Mitchell | Counselor | 471 Howe Hill Road, Greenwood, ME 04255 | 2020-10-30 |
| 1245862150 | Jing Ye | Counselor | 165 Captain John Parker Rd, Phippsburg, ME 04562-4546 | 2020-02-08 |
| 1336770726 | Holly Helena Carletti Alivizatos | Counselor | 43 Coach Lantern Ln W, Scarborough, ME 04074-8510 | 2020-02-04 |
| 1437780590 | Cheryl Bedan | Counselor | 300 Portland Rd Ste 1, Bridgton, ME 04009-4227 | 2020-01-28 |
| 1427694546 | Gerard Fitzgerald | Counselor | 303 Coopers Mills Rd, Windsor, ME 04363-3825 | 2019-11-24 |
| 1922658988 | Bailey G Knox | Counselor | 64 Lisbon St Ste 2, Lewiston, ME 04240-8064 | 2019-09-12 |
| 1780233445 | Amy Marie Tardy | Counselor | 325 Kmd, Building D - Unit 4, 325 Kmd - Building D -- Unit 4, Waterville, ME 04901 | 2019-09-05 |
| 1467928317 | Carlos Lopez & Associates LLC | Counselor | 213 W. Broadway, Lincoln, ME 04457 | 2018-10-18 |
| 1609368877 | Laurie Mclean Reckendorf | Counselor | 16 Jamesey Court, Suite 100, New Harbor, ME 04554 | 2018-06-04 |
| 1215434477 | Kelley Anne Hill | Counselor | 17 Houston Lane, Brewer, ME 04412 | 2018-04-12 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on JILL 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.