JENNIFER WALLACE (NPI# 1295083897) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295083897 |
| Entity Type | Individual |
| Full Name | JENNIFER WALLACE |
| Practice Address |
4226 Green Lake Rd West Bloomfield MI 48323-1139 |
| Practice Telephone | 2484045616 |
| Mailing Telephone | 2484045616 |
| Enumeration Date | 2012-08-29 |
| Last Update Date | 2012-08-29 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103T00000X | Psychologist | 6301014813 | MI | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356968440 | Jennifer Wallace | Technician/Technologist | 2041 E 3rd Dr, Mesa, AZ 85204-1401 | 2020-07-06 |
| 1497249882 | Jennifer Laird Wallace | Licensed Practical Nurse | 4468 Duff Rd, Livingston, TX 77351-5627 | 2018-06-19 |
| 1124579602 | Jennifer Marie Wallace | Acupuncturist | 237 Avenida Del Norte, Redondo Beach, CA 90277-5702 | 2016-10-19 |
| 1174926984 | Jennifer Wallace | Specialist/Technologist | 806 Patton Chapel Trl, Hoover, AL 35226-2254 | 2014-10-07 |
| 1669799086 | Jennifer Renea Wallace | Counselor | 3802 W University Blvd Apt 8104, Durant, OK 74701-3047 | 2010-04-24 |
| 1306035431 | Jennifer L Wallace | Physical Therapist | 3891 50th Ave S, Saint Petersburg, FL 33711-4811 | 2007-10-15 |
| 1316974058 | Jennifer Wallace | Speech-Language Pathologist | 1901 Century Blvd Ne Ste 20, Atlanta, GA 30345-3300 | 2006-06-27 |
| 1992766570 | Jennifer P Wallace | Specialist | 64400 E 26th Ct, Byers, CO 80103-8539 | 2006-03-31 |
| 1730154154 | Jennifer Lyn Wallace | Family Medicine | 1235 Se Division St, Suite 208, Portland, OR 97202-1099 | 2006-02-20 |
| 1699760934 | Jennifer L Wallace | Internal Medicine | 7720 Jones Maltsberger, Suite 110, San Antonio, TX 78216 | 2005-09-13 |
| Street Address |
4226 GREEN LAKE RD |
| City | WEST BLOOMFIELD |
| State | MI |
| Zip Code | 48323-1139 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235503301 | James K. Uhes | Occupational Therapist | 2300 Haggerty Rd. Ste 2190, Lakes Medical Center, West Bloomfield, MI 48323 | 2015-11-30 |
| 1700253283 | Max Elder | Specialist/Technologist | 2387 Scotch Pine St, West Bloomfield, MI 48323 | 2015-08-31 |
| 1952792400 | Michael Cataldo | Technician, Other | 6626 Torybrooke Ct, West Bloomfield, MI 48323 | 2015-02-05 |
| 1982944666 | Steven Nathan Rives | Internal Medicine | 2300 Haggerty Rd Ste 2060, West Bloomfield, MI 48323 | 2013-02-18 |
| 1275871832 | Detroit Medical Center Sinai Grace Hospital | General Acute Care Hospital | 3495 Pine Estates Drive, West Bloomfield, MI 48323 | 2013-01-16 |
| 1295090793 | Advance Health Care System, LLC | Massage Therapist | 4267 Foxpoint, West Bloomfield, MI 48323 | 2012-07-10 |
| 1841566700 | Eduardo Rivera | Pathology | 2920 Bloomfield Shore Drive, West Bloomfield, MI 48323 | 2012-03-26 |
| 1952611782 | Debra Mary Gregory PC LLC | Social Worker | 7130 Walnut Lake Road, West Bloomfield, MI 48323 | 2010-10-14 |
| 1033362793 | Alvin Yousif Daboul | Dentist | 2332 Hiller Road, West Bloomfield, MI 48323 | 2008-10-28 |
| 1386846574 | Jerald B Maltzman | Radiology | 4744 Wendrick Dr, W. Bloomfield, MI 48323 | 2007-06-01 |
| Find all providers in zip 48323 | ||||
| Taxonomy Code | 103T00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public. |
| Notes: Source: American Psychological Association [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295292688 | Christine Allen | Psychologist | 7035 Orchard Lake Rd Ste 800, West Bloomfield, MI 48322-5301 | 2019-02-21 |
| 1912107020 | Jill Leslie Kofender | Psychologist | 5640 West Maple Rd, Suite 205, West Bloomfield, MI 48322-3718 | 2007-07-18 |
| 1891706966 | Doris Ansela Wartel | Psychologist | 6346 Ochard Lake Rd, 107, West Bloomfield, MI 48322 | 2006-08-11 |
| 1366456766 | Steven Spector | Psychologist | 5600 West Maple Rd, Suite C307, West Bloomfield, MI 48322 | 2006-07-28 |
| 1467474288 | David Jacob Wartel | Psychologist | 6346 Orchard Lake Rd, Suite 107, West Bloomfield, MI 48322-2328 | 2006-07-24 |
| 1376564591 | Lucinda Orwoll | Psychologist | 6022 W Maple Rd Ste 408, West Bloomfield, MI 48322-4408 | 2006-07-22 |
| 1164954129 | Debra Hamilton | Psychologist | 7805 Cooley Lake Rd, Suite 300, West Bloomfield, MI 48324-3537 | 2017-03-29 |
| 1245781228 | Judith Thurswell, Psyd, Lp | Psychologist | 5777 W Maple Rd, 177, West Bloomfield, MI 48322-2267 | 2016-10-14 |
| 1356716559 | Counseling Associates, Incorporated | Psychologist | 6960 Orchard Lake Rd, 100, West Bloomfield, MI 48322-4515 | 2015-12-14 |
| 1831566256 | Kimberly Blessing | Psychologist | 6892 W Maple Rd, West Bloomfield, MI 48322-3032 | 2015-09-02 |
| Find all providers in WEST BLOOMFIELD | ||||
| City | WEST BLOOMFIELD |
| Zip Code | 48323 |
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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.