RICKY WALLACE (NPI# 1538455142) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538455142 |
| Entity Type | Individual |
| Full Name | RICKY WALLACE |
| Practice Address |
10512 Innisbrook Drive Jacksonville FL 32222 |
| Mailing Address |
10512 Innisbrook Dr Jacksonville FL 32222-1363 |
| Practice Telephone | 9045344937 |
| Practice Fax Number | 8008632339 |
| Mailing Telephone | 9045344937 |
| Mailing Fax Number | 8008632339 |
| Enumeration Date | 2011-06-22 |
| Last Update Date | 2011-06-22 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 104100000X | Social Worker | Behavioral Health & Social Service Providers |
| Street Address |
10512 INNISBROOK DRIVE |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32222 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427690353 | Emergency Physicians Inc | Emergency Medicine | 9868 Family Place, Jacksonville, FL 32222 | 2019-10-11 |
| 1053874578 | Silver Linings Community Care, LLC. | Home Health Aide | 250 Cherry Ridge #1435, Jacksonville, FL 32222 | 2019-04-11 |
| 1588144802 | Fleming Total Support Services Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 6760 Portofina Ct, Jacksonville, FL 32222 | 2018-08-16 |
| 1447736293 | Phyllis N Parrish | Home Health Aide | 10506 Innisbrook Dr, Jacksonville, FL 32222 | 2018-07-16 |
| 1851880793 | Keiarra Hendrick | Clinic/Center | 250 Cherry Ridge Dr Apt 1021, Jacksonville, FL 32222 | 2018-05-07 |
| 1427573310 | Priority Love & Care, Inc. | Voluntary or Charitable | 7283 Old Middleburg Rd S, Jacksonville, FL 32222 | 2017-08-11 |
| 1801334834 | Stacey Nicole Harden | Nurse Practitioner | 9785 Corsshill Blvd, Suite 108, Jacksonville, FL 32222 | 2017-02-09 |
| 1184031841 | Andrew Todd Pinder | Family Medicine | 8355 Merchants Gate Drive, Jacksonville, FL 32222 | 2014-07-15 |
| 1477597680 | Kelly Lynne Broekhof | Registered Nurse | Bldg 2104 Massey Ave, Naval Station Mayport, Jacksonville, FL 32222 | 2006-06-16 |
| 1356883839 | Baptist Primary Care Inc | Family Medicine | 8355 Merchants Gate Dr, Jacksonville, FL 32222 | 2016-11-15 |
| Find all providers in zip 32222 | ||||
| Taxonomy Code | 104100000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| A social worker is a person who is qualified by a Social Work degree, and licensed, certified or registered by the state as a social worker to practice within the scope of that license. A social worker provides assistance and counseling to clients and their families who are dealing with social, emotional and environmental problems. Social work services may be rendered to individuals, families, groups, and the public. |
| Notes: Source: National Association of Social Workers, 2009 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326653718 | Regina Sherman | Social Worker | 10135 Gate Pkwy N Suite 1516, Jacksonville, FL 32246-8267 | 2020-09-11 |
| 1275155368 | Christy Orellana | Social Worker | 5011 Gate Parkway Bldg 100 Suite 100, Jacksonville, FL 32256 | 2020-05-11 |
| 1700412822 | Marie Vernal | Social Worker | 6051 Arlington Expressway Suite 169, Jacksonville, FL 32211 | 2020-03-20 |
| 1790325199 | Brittany Barrett | Social Worker | 1526 Parental Home Rd, Jacksonville, FL 32216-3010 | 2020-01-14 |
| 1215592654 | Giana Marie Bobka | Social Worker | 3831 Forest Blvd, Jacksonville, FL 32246-6474 | 2019-05-01 |
| 1063979532 | Morgan E Phoebus | Social Worker | 209 Sage Pl, Jacksonville, NC 28540-3109 | 2019-02-20 |
| 1629549290 | Christina Roman | Social Worker | 6810 Long Meadow Cir S, Jacksonville, FL 32244-6177 | 2018-12-07 |
| 1356826549 | Shecolby Sims | Social Worker | 11640 Tanager Dr, Jacksonville, FL 32225-2565 | 2018-10-03 |
| 1275023558 | Vernell King | Social Worker | 233 E Bay St Ste 916, Jacksonville, FL 32202-3456 | 2018-05-13 |
| 1316436660 | Sheronda Nicole Holzendorf | Social Worker | 5559 Verbena Rd, Jacksonville, FL 32209-2418 | 2018-05-02 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32222 |
Please comment or provide details below to improve the information on RICKY 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.