BENJAMIN A WALL (NPI# 1124459037) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124459037 |
| Entity Type | Individual |
| Full Name | BENJAMIN A WALL |
| Credential | MA, LPC |
| Practice Address |
3401 Berrywood Dr Ste 300 Columbia MO 65201-6515 |
| Mailing Address |
1300 E Bradford Pkwy Springfield MO 65804-4264 |
| Practice Telephone | 5737778330 |
| Mailing Telephone | 4177615000 |
| Mailing Fax Number | 4177615065 |
| Enumeration Date | 2013-12-02 |
| Last Update Date | 2019-03-25 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101Y00000X | Counselor | 2015026369 | MO | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 490025698 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659542215 | Benjamin Earl Wall | Dentist | 10894 S River Front Pkwy, South Jordan, UT 84095-5609 | 2008-03-21 |
| 1487677407 | Benjamin Evans Wall | Physical Medicine & Rehabilitation | 2800 Ashton Drive, Wilmington, NC 28412-2486 | 2006-07-25 |
| Street Address |
3401 BERRYWOOD DR STE 300 |
| City | COLUMBIA |
| State | MO |
| Zip Code | 65201-6515 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679778617 | Andrea Earlywine | Nurse Practitioner | 3401 Berrywood Dr Ste 300, Columbia, MO 65201-6515 | 2007-06-19 |
| 1841652245 | Daniel K Ostercamp | Social Worker | 3401 Berrywood Dr Ste 300, Columbia, MO 65201-6515 | 2016-03-24 |
| 1326438961 | Laura D Breitzig | Nurse Practitioner | 3401 Berrywood Dr Ste 300, Columbia, MO 65201-6515 | 2015-02-04 |
| 1245670744 | Stephanie Elizabeth Shepard | Psychiatry & Neurology | 3401 Berrywood Dr Ste 300, Columbia, MO 65201 | 2013-06-28 |
| 1801132972 | Lora Sue Rooker | Counselor | 3401 Berrywood Dr Ste 300, Columbia, MO 65201-6515 | 2012-12-18 |
| 1427369073 | Garima Singh | Psychiatry & Neurology | 3401 Berrywood Dr Ste 300, Columbia, MO 65201 | 2010-06-29 |
| 1265752067 | Laura Elizabeth Smith | Psychiatry & Neurology | 3401 Berrywood Dr Ste 300, Columbia, MO 65201-6515 | 2010-06-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134688534 | Thomas Havey | Specialist/Technologist | 600 E Stadium Boulevard, Columbia, MO 65201 | 2019-03-15 |
| 1881176121 | Darrea L Green | Nurse Practitioner | 3700 Interstate 70 Dr Se, Columbia, MO 65201 | 2018-09-04 |
| 1073092383 | Andrea L. Lingenfelter | Registered Nurse | 1605 East Broadway, Ste. 100, Columbia, MO 65201 | 2018-08-08 |
| 1144724238 | Angela Marie Richmond | Internal Medicine | 1 Hospital Dr Rm Ma423, Columbia, MO 65201 | 2018-03-22 |
| 1770092892 | Palmer's Home Care, LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 701 Hillsdale Road, Columbia, MO 65201 | 2017-09-20 |
| 1205358710 | Mitchell E Swee | Specialist/Technologist | 600 East Stadium Blvd, Columbia, MO 65201 | 2017-07-17 |
| 1659815470 | Colleen Jockin | Specialist | 100 Matc, Columbia, MO 65201 | 2016-12-13 |
| 1720535305 | Hannah Garrad | Dietitian, Registered | Columbia 3, 25 Conley Road, Columbia, MO 65201 | 2016-09-01 |
| 1043662570 | Restoration Chiropractic LLC | Chiropractor | 1413 Grindstone Plaza Drive, Columbia, MO 65201 | 2016-07-08 |
| 1306298930 | Taylor John Sirois | Chiropractor | 1413 Grindstone Plaza Dr., Columbia, MO 65201 | 2016-07-07 |
| Find all providers in zip 65201 | ||||
| Taxonomy Code | 101Y00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master’s degree and clinical experience and supervision for licensure or certification. |
| Notes: Sources: Abridged from definitions provided by the National Board of Certified Counselors and the American Association of Pastoral Counselors. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386245710 | John Edward Gough | Counselor | 2715 Colonial Dr Bldg 200a, Columbia, SC 29203-6818 | 2020-11-03 |
| 1750988804 | Teresa Q Harris | Counselor | 1024 Bradford Ridge Ln, Columbia, SC 29223-7143 | 2020-10-01 |
| 1407491830 | Mariah Keathley | Counselor | 201 W Broadway Ste 2f, Columbia, MO 65203-3842 | 2019-11-08 |
| 1962058719 | Lindsey Howard | Counselor | 610 Poplar St, Columbia, PA 17512-2101 | 2019-08-16 |
| 1174085138 | Debra A Parker | Counselor | 100 Ashland Park Ln Ste K, Columbia, SC 29210-5100 | 2019-04-01 |
| 1881152817 | Change Your Reality | Counselor | 729 True St Apt 3, Columbia, SC 29209-1659 | 2019-03-08 |
| 1104393487 | Makida Bey | Counselor | 9850 Softwater Way, Columbia, MD 21046-1887 | 2018-10-25 |
| 1942788542 | Holistic Health Advancements, LLC | Counselor | 9005 Two Notch Rd Ste 4, Columbia, SC 29223-5851 | 2018-08-06 |
| 1811483761 | Live.balanced.life.llc | Counselor | 5305 Village Center Dr Ste 176, Columbia, MD 21044-2382 | 2018-07-03 |
| 1053811729 | Sarah Ann Galatta | Counselor | 2024 Cherry Hill Dr # 201c, Columbia, MO 65203-5921 | 2018-02-19 |
| Find all providers in COLUMBIA | ||||
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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.