MRS. JENNIFER M. WALLACE (NPI# 1093927907) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093927907 |
| Entity Type | Individual |
| Full Name | MRS. JENNIFER M. WALLACE |
| Other Name | MRS. GENEVA M. WALLACE |
| Credential | M.ED |
| Practice Address |
2298 W Horizon Ridge Pkwy Suite 109 Henderson NV 89052-2696 |
| Practice Telephone | 7023637284 |
| Practice Fax Number | 7022425252 |
| Mailing Telephone | 7023637284 |
| Mailing Fax Number | 7022425252 |
| Enumeration Date | 2007-05-04 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
1118L | NV | Behavioral Health & Social Service Providers |
| X | 104100000X | Social Worker | 00561-A | NV | Behavioral Health & Social Service Providers |
| X | 106H00000X | Marriage & Family Therapist | R05387 | NV | 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 |
2298 W HORIZON RIDGE PKWY SUITE 109 |
| City | HENDERSON |
| State | NV |
| Zip Code | 89052-2696 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770614042 | John E Duerr | Marriage & Family Therapist | 2298 W Horizon Ridge Pkwy, Suite 213, Henderson, NV 89052-2696 | 2007-03-08 |
| 1932722642 | Sheilu Satyapriya | Counselor | 2298 W Horizon Ridge Pkwy, Henderson, NV 89052-2696 | 2020-05-28 |
| 1821533068 | Elizabeth Valles Montenegro | Counselor | 2298 W Horizon Ridge Pkwy, 201, Henderson, NV 89052-2696 | 2016-12-26 |
| 1952844409 | Alisha Abramson | Marriage & Family Therapist | 2298 W Horizon Ridge Pkwy, Henderson, NV 89052-2696 | 2016-11-30 |
| 1881046563 | Amanda Khan | Behavioral Analyst | 2298 W Horizon Ridge Pkwy, #201, Henderson, NV 89052-2696 | 2016-07-06 |
| 1689033243 | Amanda Flores | Marriage & Family Therapist | 2298 W Horizon Ridge Pkwy, Henderson, NV 89052-2696 | 2016-02-11 |
| 1841532363 | Stephanie Elizabeth Bond | Community Health Worker | 2298 W Horizon Ridge Pkwy, Henderson, NV 89052-2696 | 2013-03-22 |
| 1619219441 | Judy Ann Griffin | Community Health Worker | 2298 W Horizon Ridge Pkwy, Suite 201, Henderson, NV 89052-2696 | 2013-03-19 |
| 1881933158 | Jonathan Jacob Mix | Contractor | 2298 W Horizon Ridge Pkwy, Suite 201, Henderson, NV 89052-2696 | 2013-02-06 |
| 1851641252 | Tamika M Morris | Marriage & Family Therapist | 2298 W Horizon Ridge Pkwy, 201, Henderson, NV 89052-2696 | 2012-09-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740889112 | Nathan Michael Nasternak | Physical Therapist | 750 Coronado Center Drive, Suite 140, 2212, Henderson, NV 89052 | 2020-10-18 |
| 1558987180 | Braxton Chad Storm | Counselor | 2990 W. Sundridge Heights Pkwy, Suite #140, Henderson, NV 89052 | 2020-06-19 |
| 1558996546 | The Eye Doctor At St. Rose LLC | Eyewear Supplier (Equipment, not the service) | 2645 St. Rose Parkway, Suite C-110, Henderson, NV 89052 | 2020-03-10 |
| 1770138521 | Quinn Dentists of St. Rose, PC | Dentist | 3519 St Rose Parkway, Ste 110, Henderson, NV 89052 | 2019-08-08 |
| 1346802568 | Rickie Kwong Chin Jr. | Optometrist | 695 S. Green Valley Pkwy, Henderson, NV 89052 | 2019-07-08 |
| 1134695646 | Nu Smiles, LLC | Clinic/Center | 2810 W. Horizon Ridge Parkway, Suite #110, Henderson, NV 89052 | 2018-10-23 |
| 1003393497 | Katherine Lee Villarreal | Physical Therapist | 2930 W Horizon Pkwy, Suite 205, Henderson, NV 89052 | 2018-07-27 |
| 1790281889 | Vicki Lorraine Schmidt | Nurse Practitioner | 2900 W. Horizon Ridge Pkwy, Suite 101, Henderson, NV 89052 | 2018-04-05 |
| 1326566969 | Shelby Schiller | Social Worker | 3051 W Horizon Ridge Pkwy Ste 104a, Henderson, NV 89052 | 2017-09-04 |
| 1639696826 | Pca Ventures, LLC | Technician | 2656 Soda Butte Court, Henderson, NV 89052 | 2017-08-28 |
| Find all providers in zip 89052 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154930949 | James C Stroud | Counselor | 7525 State Highway 64 W, Henderson, TX 75652-9021 | 2020-07-28 |
| 1700428414 | Tawnia M Lindal | Counselor | 525 Engel Ave, Henderson, NV 89011-4355 | 2019-10-14 |
| 1811538317 | Nicole Mcdonagh | Counselor | 2520 Saint Rose Pkwy Ste 220a, Henderson, NV 89074-7789 | 2019-10-05 |
| 1710540729 | James Allan Hagman | Counselor | 401 Hoffman Dr Ste L, Henderson, KY 42420-3390 | 2019-04-16 |
| 1336606342 | Mountain Summits LLC | Counselor | 2520 Saint Rose Pkwy Ste 204, Henderson, NV 89074-7785 | 2019-02-26 |
| 1356810337 | Kevin A Webster | Counselor | 203 S Water St Unit 200, Henderson, NV 89015-7226 | 2018-11-19 |
| 1952890089 | Natalie Dolan | Counselor | 309 W Lake Mead Pkwy Ste 100, Henderson, NV 89015-7056 | 2018-05-03 |
| 1528556321 | Lance Everett Sellers | Counselor | 975 Seven Hills Dr Apt 3315, Henderson, NV 89052-4324 | 2018-04-26 |
| 1316440308 | Micah Jovan Smith | Counselor | 2501 N Green Valley Pkwy Ste 116-118, Henderson, NV 89014-0273 | 2018-03-15 |
| 1871091892 | Crenguta Raluca Heim | Counselor | 2050 W Warm Springs Rd Unit 1121, Henderson, NV 89014-5526 | 2018-01-24 |
| Find all providers in HENDERSON | ||||
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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.