MRS. ERIN MELISSA WALLACE (NPI# 1477063444) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477063444 |
| Entity Type | Individual |
| Full Name | MRS. ERIN MELISSA WALLACE |
| Credential | BS/CADC |
| Practice Address |
16338 N Il Highway 37 Mount Vernon IL 62864-8178 |
| Practice Telephone | 6182425835 |
| Practice Fax Number | 6182426392 |
| Mailing Telephone | 6182425835 |
| Mailing Fax Number | 6182426392 |
| Enumeration Date | 2017-10-04 |
| Last Update Date | 2017-10-04 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
IL | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 1649404708 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912337213 | Erin Elizabeth Wallace | Massage Therapist | 115 30th Ave, Apt B, Seattle, WA 98122-6229 | 2013-11-22 |
| 1396952263 | Erin Elizabeth Wallace | Pediatrics | 252 Matlock Rd Ste 330, Mansfield, TX 76063-4294 | 2007-05-17 |
| 1871713099 | Erin Renee Wallace | Speech-Language Pathologist | 16407 Azimuth Drive, Crosby, TX 77532 | 2007-04-27 |
| 1649272378 | Erin Marie Wallace | Physician Assistant | 651 Colliers Way Ste 201, Weirton, WV 26062-5055 | 2005-08-12 |
| 1083966840 | Erin Wallace | Specialist | 1951 Caleb Ave, Syracuse, NY 13206-2560 | 2012-10-03 |
| 1730405598 | Erin Michelle Wallace | Psychiatry & Neurology | 10163 Se Sunnyside Rd, Suite 490, Clackamas, OR 97015-5743 | 2010-04-19 |
| 1780842906 | Erin Wallace | Speech-Language Pathologist | 12110 Clayton Rd, Saint Louis, MO 63131-2516 | 2008-05-23 |
| Street Address |
16338 N IL HIGHWAY 37 |
| City | MOUNT VERNON |
| State | IL |
| Zip Code | 62864-8178 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124452156 | Andy L Hill | Counselor | 16338 N Il Highway 37, Mount Vernon, IL 62864-8178 | 2013-08-27 |
| 1457861270 | Wendel Arms | Counselor | 16338 N Il Highway 37, Mount Vernon, IL 62864-8178 | 2017-10-06 |
| 1053821967 | Kathy O'brien | Counselor | 16338 N Il Highway 37, Mount Vernon, IL 62864-8178 | 2017-10-05 |
| 1891205779 | Crystal Lynn Bollman | Counselor | 16338 N Il Highway 37, Mount Vernon, IL 62864-8178 | 2017-10-05 |
| 1477063436 | Rachel Stransky | Counselor | 16338 N Il Highway 37, Mount Vernon, IL 62864-8178 | 2017-10-04 |
| 1104336171 | Scott Glasgow | Counselor | 16338 N Il Highway 37, Mount Vernon, IL 62864-8178 | 2017-10-04 |
| 1821508870 | Kristina Vaughan | Spec/Tech, Health Info | 16338 N Il Highway 37, Mount Vernon, IL 62864-8178 | 2017-10-04 |
| 1730699786 | Lisa Wright | Counselor | 16338 N Il Highway 37, Mount Vernon, IL 62864-8178 | 2017-10-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619438892 | Melissa Pryer | Dietitian, Registered | 2020 Broadway, Suite 1, Mt. Vernon, IL 62864 | 2019-03-28 |
| 1487145454 | Chiropractic Wellness Center of Mt Vernon, LLC. | Chiropractor | 1009 S 42nd St Ste 5, Mount Vernon, IL 62864 | 2018-05-24 |
| 1851889208 | Kimberly Tate | Counselor | 4110 North Water Place, Mt. Vernon, IL 62864 | 2018-05-01 |
| 1871907790 | University Hematology Oncology Inc | Specialist | #11 Cusumano Professional Plaza, Mount Vernon, IL 62864 | 2014-06-18 |
| 1457771677 | Dynamic Counseling and Consultation Services | Social Worker | 3600 S Water Tower Pl, Mt Vernon, IL 62864 | 2014-04-27 |
| 1619239431 | Judith C Morgan | Counselor | 16338 N Illinois Hwy 37, Mount Vernon, IL 62864 | 2012-06-08 |
| 1073888624 | James Brian Verges | Counselor | 16338 N. Illinois Hwy 37, Mount Vernon, IL 62864 | 2012-03-15 |
| 1720352271 | Lucinda M. Holdren | Counselor | 16338 North Illinois Highway 37, Mount Vernon, IL 62864 | 2012-03-01 |
| 1780978627 | Jamie M Orange | Physical Therapy Assistant | 19958 Fairfield Rd, Mt. Vernon, IL 62864 | 2011-06-08 |
| 1780978791 | Wendy Marie Claytor | Speech-Language Pathologist | 600 E Il Hwy 15, Mount Vernon, IL 62864 | 2011-06-07 |
| Find all providers in zip 62864 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295210607 | Lindsay Susan Smith | Counselor | 401 W High St, Mount Vernon, OH 43050-2324 | 2018-10-02 |
| 1962932640 | Megan J Pickard | Counselor | 1601 E College Way # 1, Mount Vernon, WA 98273-5612 | 2017-06-15 |
| 1659611051 | Richard Rudolph Jones | Counselor | 110 No. 10th. Ave. Apt.#7x, Mount Vernon, NY 10551 | 2013-02-21 |
| 1144569948 | Paulette Erin Nathan | Counselor | 332 Hayward Ave, Mount Vernon, NY 10552-1607 | 2013-02-14 |
| 1619239431 | Judith C Morgan | Counselor | 16338 N Illinois Hwy 37, Mount Vernon, IL 62864 | 2012-06-08 |
| 1831464346 | Tyler John Hitzfield | Counselor | 120 S Norton St, Mount Vernon, OH 43050-2313 | 2012-03-16 |
| 1073888624 | James Brian Verges | Counselor | 16338 N. Illinois Hwy 37, Mount Vernon, IL 62864 | 2012-03-15 |
| 1720352271 | Lucinda M. Holdren | Counselor | 16338 North Illinois Highway 37, Mount Vernon, IL 62864 | 2012-03-01 |
| 1275835373 | Ronald M. Carlos | Counselor | 30 Fleetwood Ave, #1-g, Mount Vernon, NY 10552-2865 | 2010-11-22 |
| 1013234673 | Bobbi Jo Milbrandt | Counselor | 213 E Chestnut St, Mount Vernon, OH 43050-3404 | 2010-04-22 |
| Find all providers in MOUNT VERNON | ||||
| City | MOUNT VERNON |
| Zip Code | 62864 |
Please comment or provide details below to improve the information on MRS. ERIN MELISSA WALLACE.
| 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.