MELISSA EMILY WALLACE (NPI# 1841656311) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1841656311 |
| Entity Type | Individual |
| Full Name | MELISSA EMILY WALLACE |
| Other Name | MELISSA EMILY MARTINEZ |
| Credential | LCSW |
| Practice Address |
1014 S Florida Ave Fl 2 Lakeland FL 33803-1130 |
| Practice Telephone | 8634503067 |
| Practice Fax Number | 8633374123 |
| Mailing Telephone | 8634503067 |
| Mailing Fax Number | 8633374123 |
| Enumeration Date | 2016-01-13 |
| Last Update Date | 2020-08-10 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
SW17470 | FL | Behavioral Health & Social Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1001 E Baker St Ste 100, Plant City, FL 335633700 | 8137541885 | |
| 5296 Bloomfield Blvd, Lakeland, FL 338108221 | 2039163327 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396271243 | Melissa Wallace | Physical Therapy Assistant | 3685 Mcconnells Hwy W, Sharon, SC 29742-5710 | 2017-05-11 |
| 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 |
| 1538607767 | Melissa Wallace | Counselor | 841 Riverside Dr, Suite B, Augusta, ME 04330-8302 | 2017-02-08 |
| 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 |
1014 S FLORIDA AVE FL 2 |
| City | LAKELAND |
| State | FL |
| Zip Code | 33803-1130 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861964819 | Steven P Agelidis | Counselor | 2020 S. Florida Ave, Suite 207, Lakeland, FL 33803 | 2018-12-31 |
| 1902316201 | Kesara Mai Ngam | Massage Therapist | 117 West Oak Drive, Lakeland, FL 33803 | 2017-10-02 |
| 1396260618 | Suncoast Behavioral Solutions, LLC | Behavioral Analyst | 1920 E Edgewood Dr Apt A8, Lakeland, FL 33803 | 2017-08-08 |
| 1316484413 | Daniel Jacob Stahl | Behavior Technician | 145 East Edgewood Drive, Lakeland, FL 33803 | 2017-01-26 |
| 1780037002 | Shelley Stettinius | Behavioral Analyst | 145 East Edgewood Dr, Lakeland, FL 33803 | 2016-07-21 |
| 1396106654 | Highlands Occupational Therapy, Inc | Occupational Therapist | 2000 East Edgewood Drive, Suite 114, Lakeland, FL 33803 | 2016-03-15 |
| 1003289570 | Jayna Dinsmore | Physical Therapy Assistant | 321 Imperial Blvd, D38, Lakeland, FL 33803 | 2015-11-05 |
| 1093187429 | Healthstat Wellness Polk-lakeland | Preventive Medicine | 3215 Winter Lake Road, Lakeland, FL 33803 | 2015-10-26 |
| 1962812545 | Florida Presbyterian Homes, Inc | Nursing Facility/Intermediate Care Facility | 901 Lakeside Avenue, Lakeland, FL 33803 | 2014-05-05 |
| 1710316336 | Trinity Endodontics | Health Maintenance Organization | 1602 S. Florida Ave, Ste #1, Lakeland, FL 33803 | 2013-11-04 |
| Find all providers in zip 33803 | ||||
| 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 |
|---|---|---|---|---|
| 1689286809 | Central Florida Psychotherapy Services LLC | Social Worker | 5302 S Florida Ave Ste 200, Lakeland, FL 33813-4922 | 2020-08-19 |
| 1639797582 | Maron Sabol | Social Worker | 307a W Main St, Lakeland, FL 33815-1555 | 2020-07-08 |
| 1891335188 | Atala Counseling, Pllc | Social Worker | 1867 N Crystal Lake Dr, Lakeland, FL 33801-5955 | 2020-01-14 |
| 1659920213 | Curlene Williams | Social Worker | 4302 Glennis Dr, Lakeland, FL 33813-1914 | 2019-09-06 |
| 1386293926 | Melissa Sue Meyer | Social Worker | 348 W Highland Dr, Lakeland, FL 33813-1543 | 2019-09-06 |
| 1215581939 | Melissa F Deroxtro | Social Worker | 1014 S Florida Ave Ste 102, Lakeland, FL 33803-1130 | 2019-07-31 |
| 1831655471 | Susan Marie Coulter | Social Worker | 924 Old Polk City Rd, Lakeland, FL 33809-2335 | 2019-02-19 |
| 1811495096 | Suzanne Brabant | Social Worker | 8179 Westmont Terrace Drive, Lakeland, FL 33810 | 2018-01-23 |
| 1477905917 | Lauren Dentler | Social Worker | 4175 Mayfair Way, Lakeland, FL 33812-0824 | 2016-07-08 |
| 1447600846 | Jenna Nielsen | Social Worker | 1065 Clearpointe Way, Lakeland, FL 33813-5618 | 2016-06-16 |
| Find all providers in LAKELAND | ||||
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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.