MS. AMANDA WALLACE


Address: 1907 Kristy Ct, Longmont, CO 80504-7387
Phone: 3035075210

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).

Provider Overview

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

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 101YP2500X Counselor
Specialization: Professional
3502 CO Behavioral Health & Social Service Providers

Other Providers AMANDA WALLACE

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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

Office Location

Street Address 1907 KRISTY CT
City LONGMONT
State CO
Zip Code 80504-7387

Providers in the same zip code

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 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
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

Competitor

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City LONGMONT
Zip Code 80504

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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.

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