MS. AMANDA WALLACE (NPI# 1366635245) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1366635245 |
Entity Type | Individual |
Full Name | MS. AMANDA WALLACE |
Credential | MA, LPC |
Practice Address |
1907 Kristy Ct Longmont CO 80504-7387 |
Practice Telephone | 3035075210 |
Mailing Telephone | 3035075210 |
Enumeration Date | 2007-08-23 |
Last Update Date | 2007-08-23 |
Gender Code | F |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 101YP2500X |
Counselor Specialization: Professional |
3502 | CO | Behavioral Health & Social Service Providers |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1518249838 | Amanda Daniel Wallace | Physician Assistant | 655 Jesse Jewell Pkwy Se Ste B, Gainesville, GA 30501-3854 | 2011-09-13 |
1952808024 | Amanda Marie Wallace | Case Manager/Care Coordinator | 205 Main St E, Mohall, ND 58761-4014 | 2018-04-06 |
1306345848 | Amanda Cheyenne Wallace | Student in an Organized Health Care Education/Training Program | 3640 Colonel Glenn Hwy, Dayton, OH 45435-0001 | 2018-02-11 |
1972015659 | Amanda Wallace | Behavior Technician | 41521 W 11 Mile Rd, Novi, MI 48375-1803 | 2017-11-02 |
1154844041 | Amanda Gail Wallace | Nurse Practitioner | 142 Depot Dr, South Shore, KY 41175-9306 | 2017-07-21 |
1578097341 | Amanda Wallace | Physical Therapist | 2115 Dulles Dr, Lafayette, LA 70506-2652 | 2017-04-18 |
1649665977 | Amanda Rose Wallace | Psychiatry & Neurology | 525 E 68th St, New York, NY 10065 | 2015-04-03 |
1972908010 | Amanda Jo Wallace | Psychologist | 1500 N Westwood Blvd, Poplar Bluff, MO 63901-3318 | 2014-10-31 |
1578964888 | Amanda Leigh Wallace | Speech-Language Pathologist | 928 W Market St, Tiffin, OH 44883-2529 | 2014-09-07 |
1053725952 | Amanda Wallace | Speech-Language Pathologist | 40w310 Lafox Rd, Suite A1/b1, St Charles, IL 60175-6588 | 2014-06-18 |
Street Address |
1907 KRISTY CT |
City | LONGMONT |
State | CO |
Zip Code | 80504-7387 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1942776620 | Cinde S Yoho | Social Worker | 9485 County Road 15, Firestone, CO 80504 | 2018-10-19 |
1427544881 | Thousand Peaks Healthcare, Inc. | In Home Supportive Care | 310 Lashley St Ste 109, Longmont, CO 80504 | 2018-07-09 |
1962913962 | Melissa Frick | Counselor | 10184 E I-25 Frontage Rd, Firestone, CO 80504 | 2017-10-17 |
1558757260 | Firestone Pediatric Dentistry and Orthodontics | Dentist | 8301 Colorado Blvd, Suite 200, Firestone, CO 80504 | 2015-04-09 |
1912392671 | Ashley Lerwick | Speech-Language Pathologist | 11169 Interstate I25 Frontage Rd, Firestone, CO 80504 | 2015-03-31 |
1780077685 | Roger Leon Jorgensen | Ophthalmology | 14222 N 95 Si, Longmont, CO 80504 | 2015-03-17 |
1982942090 | Carrie Rose Fitzekam | Technician | 712 Tanagers Circle, Longmont, CO 80504 | 2013-01-24 |
1003166976 | Jennifer Lynn Mcnerney | Speech-Language Pathologist | 8197 Miller Dr, Frederick, CO 80504 | 2012-09-18 |
1821343450 | Allison Luellen | Physician Assistant | 8350 Colorado Blvd, Suite 160, Firestone, CO 80504 | 2012-07-19 |
1609132109 | Abby Elizabeth Bohall | Speech-Language Pathologist | 5132 Mt Buchanan Ave, Frederick, CO 80504 | 2012-04-09 |
Find all providers in zip 80504 |
Taxonomy Code | 101YP2500X |
Grouping | Behavioral Health & Social Service Providers |
Classification | Counselor |
Specialization | Professional |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1073135398 | Gj Counseling LLC | Counselor | 2727 Nelson Rd Apt W301, Longmont, CO 80503-9347 | 2020-05-08 |
1437799251 | Chandra Rae Lontz-smith | Counselor | 16 Mountain View Ave Ste 112, Longmont, CO 80501-3420 | 2020-01-09 |
1992285001 | Dal Marque Dumars | Counselor | 29 Highway 52 Unit 12, Longmont, CO 80504-9497 | 2018-08-17 |
1013415538 | Carl Baccellieri | Counselor | 1245 Gay St, Longmont, CO 80501-3813 | 2018-01-30 |
1912405689 | Page Christine Fischer | Counselor | 2700 E Ken Pratt Blvd, Longmont, CO 80504-5275 | 2018-01-29 |
1306359443 | Ashley Roueche | Counselor | 1446 Hover St Ste 204, Longmont, CO 80501-2485 | 2017-11-12 |
1124540695 | Amanda Dean | Counselor | 1320 Carnation Cir, Longmont, CO 80503-7543 | 2017-07-16 |
1144677576 | Faith Halverson-ramos | Counselor | 1361 Francis St Ste 201e, Longmont, CO 80501-2512 | 2016-05-16 |
1851753891 | Jonathan Benz | Counselor | 1630 Dry Creek Dr Ste 100b, Longmont, CO 80503-6405 | 2016-03-28 |
1710346010 | Lori Austin | Counselor | 1855 Lochmore Dr, Longmont, CO 80504-2364 | 2016-02-15 |
Find all providers in LONGMONT |
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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.