MEG WALLACE (NPI# 1245345750) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245345750 |
| Entity Type | Individual |
| Full Name | MEG WALLACE |
| Credential | LPC |
| Practice Address |
297 Herndon Pkwy Suite 201 Herndon VA 20170-4474 |
| Mailing Address |
12807 Kettering Dr Herndon VA 20171-2446 |
| Practice Telephone | 7034354325 |
| Practice Fax Number | 7034354325 |
| Mailing Telephone | 7034354325 |
| Mailing Fax Number | 7034354325 |
| Enumeration Date | 2006-08-21 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YP2500X |
Counselor Specialization: Professional |
1808 | VA | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | ANTHEM ID | 200642 | 01 |
| VA | CARE 1ST ID | 0600001 | 01 |
| Street Address |
297 HERNDON PKWY SUITE 201 |
| City | HERNDON |
| State | VA |
| Zip Code | 20170-4474 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215596754 | Avani Patel | Assistant Behavior Analyst | 297 Herndon Pkwy, Herndon, VA 20170-4474 | 2019-06-09 |
| 1508104126 | Kathi Whitten | Social Worker | 297 Herndon Pkwy, Ste 201, Herndon, VA 20170-4474 | 2013-01-17 |
| 1831337898 | Naderi Center for Cosmetic Surgery & Skin Care, Pllc | Otolaryngology | 297 Herndon Pkwy, Suite 101, Herndon, VA 20170-4474 | 2009-01-29 |
| 1245355197 | Northern Virginia Psychotherapy Assoc., Inc. | Social Worker | 297 Herndon Pkwy, Ste. 201, Herndon, VA 20170-4474 | 2007-03-20 |
| 1801936901 | Shervin Naderi | Plastic Surgery | 297 Herndon Pkwy, Suite 101, Herndon, VA 20170-4474 | 2007-02-07 |
| 1962565358 | Catharine B Nelson | Specialist | 297 Herndon Pkwy, Suite 202, Herndon, VA 20170-4474 | 2006-12-18 |
| 1215097944 | Theresa Jacob | Counselor | 297 Herndon Pkwy, Ste. 202, Herndon, VA 20170-4474 | 2006-12-11 |
| 1396835930 | Caroline M. Tan | Psychiatry & Neurology | 297 Herndon Pkwy, Suite 202, Herndon, VA 20170-4474 | 2006-10-13 |
| 1114039476 | Ellen M. Neal | Social Worker | 297 Herndon Pkwy, Suite 202, Herndon, VA 20170-4474 | 2006-08-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295391506 | Ashley Powell | Counselor | 435a Carlisle Dr Ste 103, Herndon, VA 20170 | 2019-05-13 |
| 1841781176 | Virginia Medical Transport, LLC. | Ambulance | 360 Herndon Pkwy Ste 700, Herndon, VA 20170 | 2018-05-22 |
| 1508378332 | Warm Touch Home Care LLC | In Home Supportive Care | 492 Alabama Dr, Herndon, VA 20170 | 2017-11-02 |
| 1154847853 | Elhady Dental Pllc | Dentist | 131 Elden St #130, Herndon, VA 20170 | 2017-08-15 |
| 1841736956 | Julian Badawy | Social Worker | 425 Carlisle Drive, Herndon, VA 20170 | 2017-01-12 |
| 1942742861 | Dr. Mojdeh Vessali Family Dentistry | Dentist | 505 Huntmar Park Drive, #150, Herndon, VA 20170 | 2016-11-09 |
| 1043614308 | Scott Taylor Young | Chiropractor | 905 Herndon Parkway, Suite B, Herndon, VA 20170 | 2014-10-15 |
| 1942614706 | Desiree Debutts Farren | Counselor | 425-b Carlisle Drive, Herndon, VA 20170 | 2014-06-19 |
| 1003229006 | Angels Home Health Care LLC | Home Health | 626 Grant Street, Suite # K, Herndon, VA 20170 | 2014-06-06 |
| 1457608986 | Dental Center of Herndon | Dentist | 1110 Elden St., Suite E108, Herndon, VA 20170 | 2012-08-15 |
| Find all providers in zip 20170 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871022582 | Paula Lynn Rainer | Counselor | 13800 Coppermine Rd Ste 144, Herndon, VA 20171-6163 | 2017-06-06 |
| 1568830172 | Paul Henry | Counselor | 714 Pine St, Herndon, VA 20170-4660 | 2015-09-14 |
| 1275877029 | Eustace John Stapler IIi | Counselor | 487 Carlisle Dr, Herndon, VA 20170-4898 | 2012-11-18 |
| 1699901405 | Thomas Curtis Overton | Counselor | 453 Carlisle Dr Ste A, Herndon, VA 20170-5611 | 2009-06-08 |
| 1639353832 | Dolores Ann Cascio | Counselor | 626 Grant St., Ste D, Herndon, VA 20170-4700 | 2007-12-24 |
| 1801070115 | Betsy S Haarmann | Counselor | 487 Carlisle Dr Ste B, Herndon, VA 20170-4899 | 2007-12-21 |
| 1336340876 | John Marshall Fox | Counselor | 297 Herndon Pkwy Ste 201, Herndon, VA 20170-4468 | 2007-05-31 |
| 1598820870 | Joan Odum Ordmandy | Counselor | 512 Herndon Pkwy Ste F, Herndon, VA 20170-5244 | 2006-12-27 |
| 1629184262 | Judith Eileen Nowinski | Counselor | 459 Carlisle Dr, Suite B, Herndon, VA 20170-4819 | 2006-08-23 |
| 1265548051 | Vasilios A Gacis | Counselor | 433a Carlisle Dr, Herndon, VA 20170-4802 | 2006-08-22 |
| Find all providers in HERNDON | ||||
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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.