COURTNEY LYNN WALLACE (NPI# 1285102533) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285102533 |
| Entity Type | Individual |
| Full Name | COURTNEY LYNN WALLACE |
| Credential | QBHP |
| Practice Address |
1507 E Race Ave Searcy AR 72143-4661 |
| Mailing Address |
1815 Pleasant Grove Rd Jonesboro AR 72401-7870 |
| Practice Telephone | 5013052359 |
| Practice Fax Number | 5013052348 |
| Mailing Telephone | 8709336886 |
| Mailing Fax Number | 8709339395 |
| Enumeration Date | 2018-11-05 |
| Last Update Date | 2018-11-05 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 171M00000X | Case Manager/Care Coordinator | Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285877217 | Courtney Brooke Wallace | Contractor | 5409 Harrington Grove Dr, Raleigh, NC 27613-5701 | 2009-04-06 |
| 1508396789 | Courtney Nicole Wallace | Audiologist | 2530 Chicago Ave Ste 450, Minneapolis, MN 55404-4127 | 2017-06-19 |
| 1548692189 | Courtney Creal Wallace | Counselor | 1432 S Shelby St, Louisville, KY 40217-1166 | 2013-08-06 |
| Street Address |
1507 E RACE AVE |
| City | SEARCY |
| State | AR |
| Zip Code | 72143-4661 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932281938 | Families, Inc. of Arkansas | Counselor | 1507 E Race Ave, Searcy, AR 72143-4661 | 2006-10-19 |
| 1346847282 | Tracy Renee Martin | Case Manager/Care Coordinator | 1507 E Race Ave, Searcy, AR 72143-4661 | 2020-10-05 |
| 1891305322 | Tammie Weston | Case Manager/Care Coordinator | 1507 E Race Ave, Searcy, AR 72143-4661 | 2020-08-10 |
| 1982214417 | Mitchell Dae Rains | Case Manager/Care Coordinator | 1507 E Race Ave, Searcy, AR 72143-4661 | 2020-08-10 |
| 1609486133 | Joel Hoggard | Case Manager/Care Coordinator | 1507 E Race Ave, Searcy, AR 72143-4661 | 2020-08-10 |
| 1053949651 | Mckenzie Deloache | Case Manager/Care Coordinator | 1507 E Race Ave, Searcy, AR 72143-4661 | 2020-03-30 |
| 1245866482 | Nichole Thomas | Case Manager/Care Coordinator | 1507 E Race Ave, Searcy, AR 72143-4661 | 2020-03-19 |
| 1639705874 | Ashley Horne | Case Manager/Care Coordinator | 1507 E Race Ave, Searcy, AR 72143-4661 | 2020-03-19 |
| 1215571856 | Kaitlyn Lanae Carr | Counselor | 1507 E Race Ave, Searcy, AR 72143-4661 | 2019-11-06 |
| 1295384246 | Ashtyn Alexis Muckelberg | Case Manager/Care Coordinator | 1507 E Race Ave, Searcy, AR 72143-4661 | 2019-09-11 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679188874 | Jessalyn Elise Tackett | Pharmacist | 200 E. Race Ave, Searcy, AR 72143 | 2020-09-14 |
| 1528697620 | Edward Lee | Student in an Organized Health Care Education/Training Program | 3214 E Race St, Searcy, AR 72143 | 2020-04-02 |
| 1700420338 | Rebecca Joanne Yauilla | Family Medicine | 3214 Race Avenue, Searcy, AR 72143 | 2019-11-06 |
| 1558913517 | The Forge Counseling Group LLC | Counselor | 505 S Elm St Suite C, Searcy, AR 72143 | 2019-07-10 |
| 1023584620 | Lisa Farley | Speech-Language Pathologist | 2918 Hawkins Drive, Searcy, AR 72143 | 2018-10-22 |
| 1144761719 | Christie Brooks | Dietitian, Registered | 91 Lakeway Drive, Searcy, AR 72143 | 2017-03-16 |
| 1639626112 | Kelly Walls | Pharmacist | 805 E Park Ave, Searcy, AR 72143 | 2016-09-01 |
| 1417316480 | Zach Wickes | Student in an Organized Health Care Education/Training Program | 506 N Van, Searcy, AR 72143 | 2016-02-18 |
| 1982081592 | Bethel Burris Oliver Pllc | Dentist | 3245 E. Race St, Searcy, AR 72143 | 2015-05-04 |
| 1053798116 | Ronnie Harlow | Rehabilitation Practitioner | 1005 East Park, Jim Citty Football and Athletic Training Facility, Searcy, AR 72143 | 2015-04-28 |
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| Taxonomy Code | 171M00000X |
| Grouping | Other Service Providers |
| Classification | Case Manager/Care Coordinator |
| A person who provides case management services and assists an individual in gaining access to needed medical, social, educational, and/or other services. The person has the ability to provide an assessment and review of completed plan of care on a periodic basis. This person is also able to take collaborative action to coordinate the services with other providers and monitor the enrollee’s progress toward the cost-effective achievement of objectives specified in the plan of care. Credentials may vary from an experience in the fields of psychology, social work, rehabilitation, nursing or a closely related human service field, to a related Assoc of Arts Degree or to nursing credentials. Some states may require certification in case management. |
| Notes: Source: CMS State Medicaid Manual Section 4442.3 [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932696655 | Patrick James Hawkins | Case Manager/Care Coordinator | 1507 E. Race St, Searcy, AR 72143-4661 | 2018-04-18 |
| 1467861997 | Caitlin Forcier | Case Manager/Care Coordinator | 403 S Poplar St Ste 4, Searcy, AR 72143-6017 | 2014-08-08 |
| 1053603720 | Rebecca Rae Wagstaff | Case Manager/Care Coordinator | 3216 E Moore Ave Apt 24, Searcy, AR 72143-4894 | 2011-05-12 |
| 1326330531 | Anita Dillard | Case Manager/Care Coordinator | 400 Llama Street, Searcy, AR 72143 | 2011-05-05 |
| 1962715128 | Stephanie Sagers | Case Manager/Care Coordinator | 3090 East Race Ave, Searcy, AR 72143 | 2010-07-16 |
| 1821312125 | Amy Piker | Case Manager/Care Coordinator | 1507 E Race St, Searcy, AR 72143-4661 | 2010-03-16 |
| 1902135643 | Seth Matthews | Case Manager/Care Coordinator | 400 Llama, Searcy, AR 72143 | 2009-12-09 |
| 1063740256 | Pamela Corrine Threet | Case Manager/Care Coordinator | 3204 E Moore St, Searcy, AR 72143-4826 | 2009-11-26 |
| 1740457290 | Lauren Lawson | Case Manager/Care Coordinator | 309 Race, Searcy, AR 72143 | 2008-05-14 |
| 1134343205 | Andrew Lee Morris Jr. | Case Manager/Care Coordinator | 1507 E. Race, Searcy, AR 72143 | 2007-04-12 |
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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.