MS. KIMBERLY WALLACE (NPI# 1083091987) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083091987 |
| Entity Type | Individual |
| Full Name | MS. KIMBERLY WALLACE |
| Credential | LPC |
| Practice Address |
1944 Brannan Rd Mcdonough GA 30253-4310 |
| Practice Telephone | 6782896981 |
| Practice Fax Number | 6782896983 |
| Mailing Telephone | 6782896981 |
| Mailing Fax Number | 6782896983 |
| Enumeration Date | 2015-04-29 |
| Last Update Date | 2015-04-29 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YP2500X |
Counselor Specialization: Professional |
LPC008384 | GA | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033457791 | Kimberly Wallace | Physical Therapist | 421 W School House Ln Unit 2, Philadelphia, PA 19144-4557 | 2013-01-30 |
| 1942592340 | Kimberly Wallace | Counselor | 1427 Se 182nd Ave, Portland, OR 97233-5008 | 2011-05-04 |
| 1669794137 | Kimberly Wallace | Registered Nurse | 214 Rosewood Ter, Cheektowaga, NY 14225-3016 | 2010-02-24 |
| 1770627705 | Kimberly Shannon Wallace | Family Medicine | 1438 Defense Hwy Suite 201, Gambrills, MD 21054 | 2007-02-15 |
| 1144881640 | Kimberly Veronica Wallace | Advanced Practice Midwife | 100 Lillian Gish Blvd Sw Ste 201, Massillon, OH 44647-6500 | 2019-06-25 |
| 1316413271 | Kimberly Pauline Wallace | Pharmacist | 951 Central St, Franklin, NH 03235-2028 | 2018-10-18 |
| 1942705223 | Kimberly Wallace | Technician | 1312 S 8th St, Las Vegas, NV 89104-1638 | 2018-03-28 |
| 1043713936 | Kimberly Louise Wallace | Registered Nurse | 2040 Babcock Rd Ste 304, San Antonio, TX 78229-4428 | 2018-03-16 |
| 1265969133 | Kimberly Wallace | Registered Nurse | 3400 Bainbridge Ave, Bronx, NY 10467-2404 | 2017-05-22 |
| 1750785622 | Kimberly Wallace | Licensed Practical Nurse | 138 North Court Street, Wampsville, NY 13163 | 2014-10-21 |
| Street Address |
1944 BRANNAN RD |
| City | MCDONOUGH |
| State | GA |
| Zip Code | 30253-4310 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316176860 | Clyde William Sandford | Counselor | 1944 Brannan Rd, Mcdonough, GA 30253-4310 | 2009-07-06 |
| 1174166029 | Tommie Lee Snow | Counselor | 1944 Brannan Rd, Mcdonough, GA 30253-4310 | 2019-10-23 |
| 1629627195 | Tiffany Ann Austin | Social Worker | 1944 Brannan Rd, Mcdonough, GA 30253-4310 | 2019-09-08 |
| 1891343596 | Stacy Blalock | Counselor | 1944 Brannan Rd, Mcdonough, GA 30253-4310 | 2019-08-27 |
| 1912417528 | Dawn Niles | Counselor | 1944 Brannan Rd, Mcdonough, GA 30253-4310 | 2017-10-09 |
| 1154862258 | Julie Martin | Counselor | 1944 Brannan Rd, Mcdonough, GA 30253-4310 | 2017-03-09 |
| 1427596519 | Ashley Carr | Counselor | 1944 Brannan Rd, Mcdonough, GA 30253-4310 | 2017-02-08 |
| 1467900050 | Christyn Walker | Counselor | 1944 Brannan Rd, Mcdonough, GA 30253-4310 | 2016-09-13 |
| 1891174900 | Staci Stephens | Counselor | 1944 Brannan Rd, Mcdonough, GA 30253-4310 | 2015-05-21 |
| 1245622752 | Mary Keller | Counselor | 1944 Brannan Rd, Mcdonough, GA 30253-4310 | 2015-02-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518565159 | First Choice Home Health Care LLC | In Home Supportive Care | 600 Westridge Parkway, Suite 707, Mcdonough, GA 30253 | 2020-10-15 |
| 1164033783 | Tanequa S Dorsey | Counselor | 40 Macon Street, Suite D, Mcdonough, GA 30253 | 2020-08-17 |
| 1396369195 | Ikponmwosa Obakpolor | Physical Therapist | 234 Village Drive, Mcdonough, GA 30253 | 2020-06-08 |
| 1205392305 | Healthstat Onsite Clinic-henry County | Preventive Medicine | 141 Henry Parkway, Healthstat Clinic, Mcdonough, GA 30253 | 2019-02-13 |
| 1588128557 | Vernette R Mathurin | Licensed Practical Nurse | 97 Atl Street Suite 100, Mcdonough, GA 30253 | 2019-01-24 |
| 1083196836 | Peta-gaye C Pilote | Registered Nurse | 319 Regal Way E, Mcdonough, GA 30253 | 2018-08-29 |
| 1275021586 | Heritage Medical Supply LLC | Durable Medical Equipment & Medical Supplies | 155 Westridge Pkwy Ste 217, Mcdonough, GA 30253 | 2018-04-23 |
| 1457853236 | Sherrille Greene | Counselor | 609 Autumn Leaf Circle, Mcdonough, GA 30253 | 2018-03-07 |
| 1376052696 | Kendra Oreggio | Private Vehicle | 117 Janney Circle, Mcdonough, GA 30253 | 2017-09-29 |
| 1245758788 | Pamela Hobbs | Home Health Aide | 5011 Monarch Dr, Mcdonough, GA 30253 | 2017-09-05 |
| Find all providers in zip 30253 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679180756 | River Haven Counseling Center, LLC | Counselor | 103 Jonesboro Rd Ste K, Mcdonough, GA 30253-3169 | 2020-09-23 |
| 1598376006 | Ltanya Daniel | Counselor | 207 Olde Town Way, Mcdonough, GA 30252-6887 | 2020-08-10 |
| 1043831605 | Kourtney K Buchanan | Counselor | 8015 Chapman Ter, Mcdonough, GA 30252-8604 | 2020-05-05 |
| 1831730456 | Shirley Tate Chambers | Counselor | 1270 Upchurch Rd, Mcdonough, GA 30252-8557 | 2019-10-04 |
| 1386285070 | Koriand'r Comegys | Counselor | 1725 Pennsylvania Ave, Mcdonough, GA 30253-9118 | 2019-10-03 |
| 1295386167 | Haley Reed | Counselor | 475 Crumbley Rd, Mcdonough, GA 30252-4412 | 2019-09-23 |
| 1629538277 | Regina Yvette Davis | Counselor | 228 Daisy Cir, Mcdonough, GA 30252-1040 | 2019-03-20 |
| 1619404092 | Sonya Snow | Counselor | 1944 Brannan Road, Mcdonough, GA 30253-2217 | 2017-05-17 |
| 1255781332 | Javonne Darling | Counselor | 801 Colwell Ln, Mcdonough, GA 30253-8082 | 2016-06-20 |
| 1558718700 | Tara Zellous | Counselor | 1775 Pennsylvania Ave, Mcdonough, GA 30253-9118 | 2016-05-18 |
| Find all providers in MCDONOUGH | ||||
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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.