LISA WALLACE


Address: 2769 Iris Ave Ste 107, Boulder, CO 80304-4405
Phone: 9703689185

LISA WALLACE (NPI# 1336779925) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1336779925
Entity Type Individual
Full Name LISA WALLACE
Credential LPC
Practice Address 2769 Iris Ave Ste 107
Boulder
CO 80304-4405
Mailing Address 1600 Bradley Ct
Boulder
CO 80305-7310
Practice Telephone 9703689185
Mailing Telephone 9703893612
Enumeration Date 2020-01-22
Last Update Date 2020-01-22
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 101YP2500X Counselor
Specialization: Professional
0015978 CO Behavioral Health & Social Service Providers

Other Provider Identifier

State Issuer Identifier Type Code
CO CAQH 14607457 01

Other Providers LISA WALLACE

NPI Name Taxonomy Address Enumeration
1396368064 Lisa Jean Wallace Occupational Therapy Assistant 480 Somerset St Unit 1, North Plainfield, NJ 07060-4018 2020-05-28
1710521968 Lisa Anne Wallace Counselor 418 Barr Rd, Lexington, SC 29072-2363 2019-10-31
1598225930 Lisa Buckner Wallace Counselor 3750 N Center St, Hickory, NC 28601-8089 2019-03-21
1235637182 Lisa M. Wallace Nurse Practitioner 800 E Cheves St Ste 200, Florence, SC 29506-2651 2018-01-25
1134575475 Lisa Wallace Counselor 14 Farmer Rd, Milton, MA 02186-3743 2016-05-05
1720476641 Lisa Wallace Registered Nurse 7601 Hospital Dr Ste 202, Sacramento, CA 95823-5408 2014-12-30
1134438286 Lisa M Wallace Nurse Practitioner 831 N Theatre Drive, Marion, IN 46952-1701 2010-10-06
1124002571 Lisa M Wallace Counselor 1807 Capitol Ave, Suite 101 A, Cheyenne, WY 82001-4544 2005-11-30
1003423658 Lisa Carol Wallace Nurse Practitioner 2418 180th St, Allerton, IA 50008-8715 2020-09-28
1992368872 Lisa Wallace Licensed Practical Nurse 27777 Inkster Rd, Farmington Hills, MI 48334-5326 2019-04-17

Office Location

Street Address 2769 IRIS AVE STE 107
City BOULDER
State CO
Zip Code 80304-4405

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1720605256 Evol.v Chiropractic LLC Chiropractor 2401 Broadway #208, Boulder, CO 80304 2020-07-01
1760038723 Patrica Anne Zeyher Counselor 100 Alpine Ave., Boulder, CO 80304 2019-08-15
1356855928 Opal Counseling Center, LLC Counselor 1480 Lee Hill Dr. #7, Boulder, CO 80304 2017-11-19
1831608603 Lesley Ann Cloke Dietitian, Registered 1895 Bluff St., Unit C, Boulder, CO 80304 2017-09-25
1790209740 Megan Litwiller Occupational Therapist 810 Maxwell Ave, Boulder, CO 80304 2017-08-01
1285163774 Nadine Martin Registered Nurse 311 Mapleton Ave # 331, Boulder, CO 80304 2017-06-08
1598119281 Megan Cronin Larson Social Worker 825 S. Broadway Street, Boulder, CO 80304 2016-04-19
1760844237 Rafia Rebeck Counselor 1235 Elder Ave #7, Boulder, CO 80304 2016-03-24
1629441688 Jennifer S Delaney Counselor 2334 Broadway, Ste. B, Boulder, CO 80304 2015-11-12
1891162301 Kingston Dialysis LLC Clinic/Center 2880 Folsom St Ste 110, Boulder, CO 80304 2015-09-01
Find all providers in zip 80304

Taxonomy Information

Taxonomy Code 101YP2500X
Grouping Behavioral Health & Social Service Providers
Classification Counselor
Specialization Professional

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1881205466 Sara Horn Counselor 4650 White Rock Cir Apt 12, Boulder, CO 80301-5373 2020-08-16
1669095618 Allison Margaret Leddy Villarreal Counselor 737 29th St Ste 200f, Boulder, CO 80303-2474 2020-05-26
1265053961 Positive Regard Psychotherapy Pllc Counselor 3102 Gamow Ln, Boulder, CO 80301-5465 2020-05-04
1154953776 Willow Mae Arlenea Counselor 4500 19th St Lot 379, Boulder, CO 80304-0663 2020-02-11
1952952764 Lauren Bleu Northrup Counselor 170 Seminole Dr, Boulder, CO 80303-4227 2019-09-23
1750947289 Shelly Froehlich Counselor 1637 28th St Ste 201, Boulder, CO 80301-1001 2019-05-09
1003470139 Kim Ann Merrill Counselor 6658 Gunpark Dr Ste 201, Boulder, CO 80301-3375 2019-04-24
1477019222 Elizabeth Ann Maher Counselor 4949 Broadway St Ste 201, Boulder, CO 80304-0578 2019-02-18
1124592225 Stepheny Antrobus Counselor 100 Arapahoe Lane, Suite 12, Boulder, CO 80302 2019-01-11
1679042766 Julie Lynn Holburn Counselor 737 29th St Ste 200-g, Boulder, CO 80303-2317 2018-11-18
Find all providers in BOULDER

Competitor

Search similar providers

City BOULDER
Zip Code 80304

Improve Information

Please comment or provide details below to improve the information on LISA WALLACE.

Dataset Information

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.

Trending Searches