MR. BARRY RAY WALLACE JR. (NPI# 1841858875) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1841858875 |
| Entity Type | Individual |
| Full Name | MR. BARRY RAY WALLACE JR. |
| Practice Address |
2101 Garner Rd #107 Raleigh NC 27610-3790 |
| Mailing Address |
5440 Eagle Cloud Trl Apt 301 Raleigh NC 27606-3790 |
| Practice Telephone | 9197876131 |
| Enumeration Date | 2019-06-04 |
| Last Update Date | 2019-08-27 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
25403 | NC | Behavioral Health & Social Service Providers |
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
A15095 | NC | Behavioral Health & Social Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 5440 Eagle Cloud Trl Apt 301, Raleigh, NC 276063790 | 2523498421 |
| Street Address |
2101 GARNER RD #107 |
| City | RALEIGH |
| State | NC |
| Zip Code | 27610-3790 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609499243 | Elizabeth Ranganai Mavindidze | Social Worker | Wakemed Health and Hospitals, 3000 New Bern Avenue, Raleigh, NC 27610 | 2020-05-18 |
| 1851958839 | Alex & Associates, P.C. | Dentist | 1600 Cross Link Road, Unit 103, Raleigh, NC 27610 | 2019-05-24 |
| 1639646367 | Carol Mary Medins | Dietitian, Registered | Wakemed Raleigh Medical Park, 23 Sunnybrook Road, Suite 200, Raleigh, NC 27610 | 2018-10-31 |
| 1144714601 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 123 Sunnybrook Rd Ste 150, Raleigh, NC 27610 | 2018-06-19 |
| 1417446006 | Eagles Eye Lab, Inc | Clinical Medical Laboratory | 4501 New Bern Ave, Ste: 130, Raleigh, NC 27610 | 2018-05-09 |
| 1316465206 | Jeffery King Neer | Social Worker | 3010 Falstaff Rd., C/o Unc Actt, Raleigh, NC 27610 | 2017-08-31 |
| 1083139885 | Kelsey Daniel Mccleave | Social Worker | 3630 Enduring Freedom Drive, Raleigh, NC 27610 | 2017-08-14 |
| 1891219093 | Tarheel Residential Services | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 4840 Quarryman Road, Raleigh, NC 27610 | 2017-07-29 |
| 1508214826 | Compassionate Care Providers LLC | Respite Care | 5110 Wetlands, Raleigh, NC 27610 | 2016-05-26 |
| 1730552530 | Matthew Belair | Pharmacist | 1601-51 Cross Link Rd, Raleigh, NC 27610 | 2015-11-03 |
| Find all providers in zip 27610 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043811243 | Ally Health Services LLC | Counselor | 3811 Tarheel Dr Ste 106, Raleigh, NC 27609-7548 | 2020-11-04 |
| 1669070561 | Yazmeen Nilaja Irving | Counselor | 1654 Brownairs Ln, Raleigh, NC 27610-3490 | 2020-10-13 |
| 1194323980 | James P Perkins Jr. | Counselor | 4205 Wake Forest Rd Ste 101, Raleigh, NC 27609-6246 | 2020-10-13 |
| 1598362154 | Polaris Psychological Health Counseling and Consulting Services Pllc | Counselor | 181 Wind Chime Ct Ste 201, Raleigh, NC 27615-6573 | 2020-10-07 |
| 1740897099 | Nola Metz Allan | Counselor | 537 Rand Rd, Raleigh, NC 27603-8715 | 2020-09-29 |
| 1346856291 | Julie Freeman | Counselor | 2108 Langdon Rd, Raleigh, NC 27604-3616 | 2020-09-16 |
| 1104438738 | Rebekah Lynn Musselwhite | Counselor | 8512 Six Forks Rd Ste 1010, Raleigh, NC 27615-3255 | 2020-08-17 |
| 1487263026 | Better Health Counseling & Wellness, Pllc | Counselor | 5245 Pinehall Wynd, Raleigh, NC 27604-5827 | 2020-07-29 |
| 1174132021 | Kimberley Irene Gada-steinauer | Counselor | 4913 Professional Ct Ste 207, Raleigh, NC 27609-1926 | 2020-07-27 |
| 1780202085 | Tessa Blair Nayowith | Counselor | 6512 Six Forks Rd Ste 403b, Raleigh, NC 27615-6526 | 2020-07-13 |
| Find all providers in RALEIGH | ||||
Please comment or provide details below to improve the information on MR. BARRY RAY WALLACE JR..
| 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.