COURTNEY CREAL WALLACE (NPI# 1548692189) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548692189 |
| Entity Type | Individual |
| Full Name | COURTNEY CREAL WALLACE |
| Credential | LCSW, CADC |
| Practice Address |
1432 S Shelby St Louisville KY 40217-1166 |
| Mailing Address |
1436 S Shelby St Louisville KY 40217-1107 |
| Practice Telephone | 5026354538 |
| Practice Fax Number | 5026354570 |
| Mailing Telephone | 5026354538 |
| Mailing Fax Number | 5026354570 |
| Enumeration Date | 2013-08-06 |
| Last Update Date | 2014-05-28 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
1771 | KY | Behavioral Health & Social Service Providers |
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
3882 | KY | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285877217 | Courtney Brooke Wallace | Contractor | 5409 Harrington Grove Dr, Raleigh, NC 27613-5701 | 2009-04-06 |
| 1285102533 | Courtney Lynn Wallace | Case Manager/Care Coordinator | 1507 E Race Ave, Searcy, AR 72143-4661 | 2018-11-05 |
| 1508396789 | Courtney Nicole Wallace | Audiologist | 2530 Chicago Ave Ste 450, Minneapolis, MN 55404-4127 | 2017-06-19 |
| Street Address |
1432 S SHELBY ST |
| City | LOUISVILLE |
| State | KY |
| Zip Code | 40217-1166 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427265172 | Lynda Porter | Specialist | 1432 S Shelby St, Louisville, KY 40217-1176 | 2007-05-16 |
| 1215352943 | Heather Pauline | Counselor | 1432 S Shelby St, Louisville, KY 40217-1166 | 2014-03-05 |
| 1801003173 | Marlene Crowe | Counselor | 1432 S Shelby St, Louisville, KY 40217-1176 | 2007-05-17 |
| 1316154008 | Volunteers of America of Kentucky Inc | Counselor | 1432 S Shelby St, Louisville, KY 40217-1176 | 2007-05-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720564016 | Kaela Marie Turley | Nurse Practitioner | 2355 Poplar Level Rd Ste 405, Louisville, KY 40217 | 2018-07-19 |
| 1740710623 | Landmark of Louisville Rehabilitation and Nursing Center | Skilled Nursing Facility | 1155 Eastern Parkway, Louisville, KY 40217 | 2017-06-14 |
| 1386185437 | Meredith Brooke Ervin | Counselor | 1169 Eastern Pkwy Ste 3310, Louisville, KY 40217 | 2017-03-08 |
| 1437507621 | Kendra Pickerill | Speech-Language Pathologist | 906 Delor Avenue, Louisville, KY 40217 | 2016-05-27 |
| 1275947186 | Gary Muncy | Massage Therapist | 607 East Brandeis Ave, Louisville, KY 40217 | 2014-06-18 |
| 1912318791 | Stacey Charlotte Elmes | Case Manager/Care Coordinator | 2338 Alexanderave, Louisville, KY 40217 | 2014-05-14 |
| 1275819831 | April Mecasha Cox | Pharmacist | 808 Eastern Parkway, Louisville, KY 40217 | 2011-10-27 |
| 1831346204 | Nikki Renee Wilson | Registered Nurse | 1169 Eastern Pkwy Ste 1226, Louisville, KY 40217 | 2008-08-27 |
| 1497925440 | Sarah Beth Murrow | Chiropractor | 1100 Milton St, Louisville, KY 40217 | 2008-03-06 |
| 1457560302 | Ferenc Pantaleone Nagy | Surgery | 3 Audubon Plaza Dr Ste 220, Louisville, KY 40217 | 2007-05-21 |
| Find all providers in zip 40217 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730797911 | Harvetta K Ray | Social Worker | 1426 S 28th St, Louisville, KY 40211-1729 | 2020-07-14 |
| 1083235360 | Julie Elfers | Social Worker | 700 Front St Ste 208, Louisville, CO 80027-1805 | 2020-04-28 |
| 1699301291 | James Casey Newman | Social Worker | 7121 Black Walnut Cir, Louisville, KY 40229-6402 | 2020-03-16 |
| 1467086744 | Kathryn Fischer | Social Worker | 1009 Rosemary Dr, Louisville, KY 40213-1119 | 2020-02-26 |
| 1497385496 | Katelyn Mensing | Social Worker | 531 W Whitney Ave Apt 1, Louisville, KY 40215-2835 | 2020-01-19 |
| 1386280683 | Jayan Thomas Lcsw LLC | Social Worker | 13113 Eastpoint Park Blvd Ste G, Louisville, KY 40223-4191 | 2019-11-21 |
| 1619511615 | Children's Safe Haven, LLC | Social Worker | 1939 Goldsmith Ln Ste 130, Louisville, KY 40218-3175 | 2019-11-01 |
| 1518500693 | Samantha Catherine Renschler | Social Worker | 4010 Dupont Cir Ste 300, Louisville, KY 40207-4881 | 2019-10-22 |
| 1124660287 | Andrea Bland | Social Worker | 4820 Greenvale Cir, Louisville, KY 40272-3181 | 2019-10-10 |
| 1164063665 | Lisa Spencer | Social Worker | 3906 Wewoka Ave, Louisville, KY 40212-2852 | 2019-10-05 |
| Find all providers in LOUISVILLE | ||||
| City | LOUISVILLE |
| Zip Code | 40217 |
Please comment or provide details below to improve the information on COURTNEY CREAL 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.