MR. DARRELL DEWAYNE WALLACE JR. (NPI# 1265086367) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265086367 |
| Entity Type | Individual |
| Full Name | MR. DARRELL DEWAYNE WALLACE JR. |
| Credential | LGPC |
| Practice Address |
107 E 25th St Baltimore MD 21218-5213 |
| Mailing Address |
553 Marc Rd # A Millersville MD 21108-1525 |
| Practice Telephone | 4105580019 |
| Mailing Telephone | 4436947554 |
| Enumeration Date | 2019-07-26 |
| Last Update Date | 2019-07-26 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
LGP9687 | MD | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447496922 | Darrell Y Wallace | Acupuncturist | The Concord Clinic, 56 Winthrop Street, Concord, MA 01742 | 2009-01-05 |
| Street Address |
107 E 25TH ST |
| City | BALTIMORE |
| State | MD |
| Zip Code | 21218-5213 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497977169 | All Walks of Life, LLC | Community/Behavioral Health | 107 E 25th St, Baltimore, MD 21218-5213 | 2007-05-03 |
| 1558975862 | Ray Thad Woodson | Counselor | 107 E 25th St, Baltimore, MD 21218-5213 | 2020-09-03 |
| 1619594231 | Ayana Harlee | Social Worker | 107 E 25th St, Baltimore, MD 21218-5213 | 2020-06-30 |
| 1265056774 | Nicole Latasha Shell | Registered Nurse | 107 E 25th St, Baltimore, MD 21218-5213 | 2020-05-31 |
| 1548895154 | Tyranny Smith | Social Worker | 107 E 25th St, Baltimore, MD 21218-5213 | 2020-03-04 |
| 1518599018 | De'ja Y Geter-jackson | Student in an Organized Health Care Education/Training Program | 107 E 25th St, Baltimore, MD 21218-5213 | 2020-02-12 |
| 1083245799 | Dennis Nyabeni Barare | Social Worker | 107 E 25th St, Baltimore, MD 21218-5213 | 2020-01-31 |
| 1194356824 | Latonya Epps | Social Worker | 107 E 25th St, Baltimore, MD 21218-5213 | 2020-01-31 |
| 1730710559 | Mi-cha-el B West Jr. | Social Worker | 107 E 25th St, Baltimore, MD 21218-5213 | 2020-01-30 |
| 1144850991 | Jade Nesbitt | Social Worker | 107 E 25th St, Baltimore, MD 21218-5213 | 2020-01-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851933725 | Tierra Bouyer | Speech-Language Pathologist | 2040 East 32nd Street, Baltimore, MD 21218 | 2019-10-12 |
| 1093273559 | Brenda H. Wells | Social Worker | 200 E. North Ave., Baltimore, MD 21218 | 2019-03-04 |
| 1619441011 | Harwood Behavioral Health Partners, LLC | Community/Behavioral Health | 2514 Greenmount Avenue, Baltimore, MD 21218 | 2019-01-18 |
| 1649740291 | Elise Christine Starkey | Occupational Therapist | 801 Argonne Drive, Baltimore, MD 21218 | 2018-11-27 |
| 1851861421 | Alagra S Bass | Social Worker | 1900 N. Howard Street Suite 300, Baltimore, MD 21218 | 2018-11-27 |
| 1396213575 | Desiree Luerene Israel | Social Worker | 2000 Greenmount Ave Ste 101, Baltimore, MD 21218 | 2018-11-06 |
| 1952885451 | Harwood Behavioral Health Partners, LLC | Clinic/Center | 2514 Greenmount Ave, Baltimore, MD 21218 | 2018-09-20 |
| 1528548047 | Rozi Khan | Student in an Organized Health Care Education/Training Program | 325 East University Pkwy 1-3, Bltimore, MD 21218 | 2018-08-14 |
| 1558866202 | Prabij N/a Dhungana | Student in an Organized Health Care Education/Training Program | 201 E. University Parkway, Dept of Medicine, Baltimore, MD 21218 | 2018-03-26 |
| 1588163562 | Generation 5 Healthcare, Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 707 Belgian Ave., Baltimore, MD 21218 | 2018-02-06 |
| Find all providers in zip 21218 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477154482 | Inner Alchemy LLC | Counselor | 629 S Streeper St, Baltimore, MD 21224-3831 | 2020-11-05 |
| 1962002709 | This Generation Will Succeed, LLC | Counselor | 2835 Odonnell St Ste 203, Baltimore, MD 21224-4995 | 2020-10-30 |
| 1174123244 | Alexia N Smith | Counselor | 841 E Fort Ave # 385, Baltimore, MD 21230-5117 | 2020-10-28 |
| 1578179396 | Jomar Nicholas Mcfarlane | Counselor | 141 N Patterson Park Ave, Baltimore, MD 21231-1659 | 2020-09-17 |
| 1871106559 | Diana Harden | Counselor | 5022 Campbell Blvd # L-m, Baltimore, MD 21236-4969 | 2020-08-24 |
| 1053922708 | Shaindel Edelman | Counselor | 17 Warren Rd Ste 25b, Baltimore, MD 21208-5334 | 2020-08-14 |
| 1912524323 | Lydia Hubbard | Counselor | 1800 N Charles St Ste 1600, Baltimore, MD 21201-5920 | 2020-07-01 |
| 1184249922 | Building People Behavioral Health | Counselor | 2140 Mcculloh St, Baltimore, MD 21217-3529 | 2020-06-08 |
| 1033733274 | The Improving Quality of Life, LLC | Counselor | 5602 Baltimore National Pike Suite 300, Baltimore, MD 21228-1410 | 2020-06-03 |
| 1053933986 | David Lewis | Counselor | 125 N Hilton St, Baltimore, MD 21229-3748 | 2020-05-14 |
| Find all providers in BALTIMORE | ||||
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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.