MELISSA WALLACE (NPI# 1538607767) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538607767 |
| Entity Type | Individual |
| Full Name | MELISSA WALLACE |
| Credential | CADC |
| Practice Address |
841 Riverside Dr Suite B Augusta ME 04330-8302 |
| Practice Telephone | 8442945306 |
| Practice Fax Number | 8442945306 |
| Mailing Telephone | 8442945306 |
| Mailing Fax Number | 8442945306 |
| Enumeration Date | 2017-02-08 |
| Last Update Date | 2017-02-08 |
| 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) |
CAC3136 | ME | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396271243 | Melissa Wallace | Physical Therapy Assistant | 3685 Mcconnells Hwy W, Sharon, SC 29742-5710 | 2017-05-11 |
| 1841656311 | Melissa Emily Wallace | Social Worker | 1014 S Florida Ave Fl 2, Lakeland, FL 33803-1130 | 2016-01-13 |
| 1285903955 | Melissa Wallace | Physical Therapist | 582 Hwy 365 Ste 3, Mayflower, AR 72106 | 2011-12-23 |
| 1619267101 | Melissa Wallace | Massage Therapist | 161 Cactus Ct, Louisville, KY 40229-3109 | 2011-04-18 |
| 1972068278 | Melissa S Wallace | Licensed Practical Nurse | 151 W 7th Ave Ste 163, Eugene, OR 97401-2676 | 2019-01-31 |
| 1881189181 | Melissa Sue Wallace | Counselor | 3575 Pershing Ave, San Diego, CA 92104-3413 | 2018-06-28 |
| 1023524501 | Melissa Ann Wallace | Nurse Practitioner | 905 University Dr, State College, PA 16801-6626 | 2017-12-20 |
| 1538609110 | Melissa Wallace | Case Manager/Care Coordinator | 1124 College Dr, Rock Springs, WY 82901-5863 | 2017-03-02 |
| 1366804064 | Melissa Wallace | Case Manager/Care Coordinator | 111 S Treaty Rd, Miami, OK 74354-5327 | 2016-03-22 |
| 1972988640 | Melissa Wallace | Social Worker | 579 Courtlandt Ave, Bronx, NY 10451-5013 | 2015-07-23 |
| Street Address |
841 RIVERSIDE DR SUITE B |
| City | AUGUSTA |
| State | ME |
| Zip Code | 04330-8302 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104163336 | Stormie Hendrickson | Student in an Organized Health Care Education/Training Program | 841 Riverside Dr, Augusta, ME 04330-8302 | 2013-01-08 |
| 1871112078 | Daniel Lau | Counselor | 841 Riverside Dr, Augusta, ME 04330-8302 | 2020-04-09 |
| 1457990350 | Dannielle Hartford | Counselor | 841 Riverside Dr, Augusta, ME 04330-8302 | 2019-12-26 |
| 1891332524 | Peggy Lee Breault | Counselor | 841 Riverside Dr, Augusta, ME 04330-8302 | 2019-12-02 |
| 1740615673 | Hearts for Healthcare | Home Health | 841 Riverside Dr, Augusta, ME 04330 | 2013-09-11 |
| 1457691263 | Anglez Behavioral Health Services Pa | Community/Behavioral Health | 841 Riverside Dr, Augusta, ME 04330-8302 | 2013-02-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770181877 | Renewal Family Center, LLC | Community/Behavioral Health | 10 Learners Drive, Augusta, ME 04330 | 2020-10-12 |
| 1134748759 | Chelsea Simone Koch | Registered Nurse | 1 Va Center, Department of Veterans Affairs, Augusta, ME 04330 | 2020-04-14 |
| 1790238442 | Nicole Lacrosse | Behavioral Analyst | 53 Hayden Rd, Augusta, ME 04330 | 2016-07-29 |
| 1093176844 | Richard J. Larrabee | Counselor | 312 Townhouse Road, Chelsea, ME 04330 | 2016-03-08 |
| 1376910984 | Sarah C. A. Tatlock | Social Worker | 41 Anthony Ave, Augusta, ME 04330 | 2015-08-31 |
| 1457728180 | Va Maine Health | General Acute Care Hospital | 1 Va Center 05, Va Maine Healthcare System-togus, Augusta, ME 04330 | 2015-08-28 |
| 1043696842 | Megan Arsenault | Pharmacist | 403 Water Street, Augusta, ME 04330 | 2015-08-04 |
| 1205219987 | Trevor Holbert | Audiologist | 1 Va Center - Togus Va Medical Center, Audiology 126a, Augusta, ME 04330 | 2015-06-30 |
| 1659787836 | Hannah M. Pullen | Occupational Therapy Assistant | 12 Shuman Ave Ste 16, Augusta, ME 04330 | 2014-07-08 |
| 1831469899 | Tanya Bernadette Quarterman | Specialist | 153 Hospital St Ste 13, Augusta, ME 04330 | 2012-01-09 |
| Find all providers in zip 04330 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316569619 | G.r.a.y.s. Group, LLC | Counselor | 1227 Augusta West Pkwy Ste 15, Augusta, GA 30909-6671 | 2020-05-11 |
| 1366078180 | Tony M Pushard | Counselor | 24 Stone St Ste 204, Augusta, ME 04330-5209 | 2020-03-13 |
| 1154956365 | Meghan E Hopper | Counselor | 24 Stone St Ste 203, Augusta, ME 04330-5209 | 2020-03-09 |
| 1932739117 | Nanci Dawn Porter | Counselor | 8 Summer St, Augusta, ME 04330-5129 | 2020-01-16 |
| 1932682200 | Douglas Paul Weaver Jr. | Counselor | 19 New England Rd, Augusta, ME 04330-0527 | 2018-09-12 |
| 1235626938 | Andrea Avery | Counselor | 24 Stone St Ste 101, Augusta, ME 04330-5209 | 2018-04-18 |
| 1962947374 | Kayla Turpin | Counselor | 218 S Spring St, Augusta, WI 54722-9385 | 2016-12-21 |
| 1831549211 | Melissa Ann Adams | Counselor | 9 Spruce St, Augusta, ME 04330-5213 | 2016-06-16 |
| 1689031296 | Teresa Maria Martin | Counselor | 1e-148, Charlie Norwood Vamc One Freedom Way, Augusta, GA 30904 | 2016-01-27 |
| 1598122269 | Jillian Wilkerson | Counselor | Charlie Norwood Veteran Affairs One Freedom Way, Substance Use Recovery Clinic, Augusta, GA 30904 | 2016-01-26 |
| Find all providers in AUGUSTA | ||||
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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.