NICOLE M. WALLACE (NPI# 1275821993) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275821993 |
| Entity Type | Individual |
| Full Name | NICOLE M. WALLACE |
| Credential | MSW, LCSW |
| Practice Address |
177 Main St Ste 206 Huntington NY 11743-6917 |
| Practice Telephone | 6313803454 |
| Enumeration Date | 2011-07-15 |
| Last Update Date | 2018-03-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 104100000X | Social Worker | 084063 | NY | Behavioral Health & Social Service Providers |
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
084663 | NY | Behavioral Health & Social Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 180 Livingston St, Suite 303, Brooklyn, NY 112015861 | 3473288110 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366735839 | Nicole Mani Wallace | Chiropractor | 219 Main St Ste A, Pineville, NC 28134-7528 | 2011-05-17 |
| 1821311606 | Nicole Broadway Wallace | Counselor | 207 Belo Dr, Killeen, TX 76542-5598 | 2010-03-08 |
| 1154820868 | Nicole Janeen Wallace | Counselor | 174 Mine Lake Ct Ste 200, Raleigh, NC 27615-6417 | 2018-02-08 |
| 1588964787 | Nicole Wallace | Physical Therapist | 3350 La Jolla Village Drive, San Diego, CA 92161 | 2010-10-22 |
| 1609089028 | Nicole Marie Wallace | Specialist | 913 First Colonial Rd Ste 204, Virginia Beach, VA 23454-3198 | 2007-05-08 |
| 1508889254 | Nicole Wallace | Physician Assistant | 1324 Lakeland Hills Blvd, Lakeland, FL 33805-4543 | 2006-07-25 |
| Street Address |
177 MAIN ST STE 206 |
| City | HUNTINGTON |
| State | NY |
| Zip Code | 11743-6917 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649674573 | Anne Robertson | Psychologist | 177 Main St Ste 206, Huntington, NY 11743-6917 | 2014-10-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447896477 | Peter C Gaal | Behavioral Analyst | 47 N. Woodhull Road, 2nd Floor, Huntington, NY 11743 | 2019-11-25 |
| 1902389299 | Taylor Bliss Dambrosio | Early Intervention Provider Agency | 38 Carnegie Ave, Huntington, NY 11743 | 2018-09-12 |
| 1639601750 | Speech and Hearing Services | Clinic/Center | 17 Brooks Ave Unit1, Huntington, NY 11743 | 2017-03-29 |
| 1174983456 | Helene Falcone | Registered Nurse | 264 W. 22nd St., Oakwood Primary Center, Hunt., NY 11743 | 2016-03-01 |
| 1124499470 | Thomas Hlenski | Social Worker | 4 Richard Lane, Huntington, NY 11743 | 2015-10-13 |
| 1174921308 | Jeanne Ginsberg | Counselor | 81 Knollwood Avenue, Huntington, NY 11743 | 2014-12-22 |
| 1770980534 | Emily Ann Sombke | Physician Assistant | 249 Manor Rd., Huntington, NY 11743 | 2014-11-21 |
| 1881096162 | Applied Health Chiropractic | Chiropractor | 12 Ash Pl, Huntington, NY 11743 | 2014-09-18 |
| 1265857643 | Ccs Medical Practice, Pllc | Public Health or Welfare | 17 Southdown Road, Huntington, NY 11743 | 2014-02-21 |
| 1255760682 | Ekaterina Femminella | Acupuncturist | 181 Main St Ste 105, Huntington, NY 11743 | 2013-11-06 |
| Find all providers in zip 11743 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083229546 | Linnea Michaels | Social Worker | 23 Tall Oak Dr, Huntington, NY 11743-7115 | 2020-09-11 |
| 1962060053 | Xylem House Counseling and Play Therapy | Social Worker | 2769 Collis Ave, Huntington, WV 25702-1318 | 2019-06-03 |
| 1639734585 | Sean Frazee | Social Worker | 1540 Spring Valley Dr # 116b, Huntington, WV 25704-9300 | 2019-05-07 |
| 1588175517 | Kerry Marie Smalling | Social Worker | 54 Newfoundland Ave, Huntington, NY 11743-4947 | 2017-10-17 |
| 1689190191 | Jeffrey J Freedlund | Social Worker | 1190 North Mohrland Road, Huntington, UT 84528 | 2017-08-16 |
| 1174067268 | Susan Bloch | Social Worker | 59 Glenna Little Trl, Huntington, NY 11743-6729 | 2016-12-08 |
| 1124499470 | Thomas Hlenski | Social Worker | 4 Richard Lane, Huntington, NY 11743 | 2015-10-13 |
| 1053709899 | Lisa Iglesias-maerz | Social Worker | 75 Prospect St Ste 208, Huntington, NY 11743-3310 | 2015-01-01 |
| 1053732065 | Mary Rocchio | Social Worker | 14 Thea Ln, Huntington, NY 11743-2318 | 2013-12-17 |
| 1770913352 | Renata Bergman | Social Worker | 24 Cherry Pl, Huntington, NY 11743-1900 | 2013-11-19 |
| Find all providers in HUNTINGTON | ||||
| City | HUNTINGTON |
| Zip Code | 11743 |
Please comment or provide details below to improve the information on NICOLE M. WALLACE.
| 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.