LOWELL WALLACE (NPI# 1932610623) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932610623 |
| Entity Type | Individual |
| Full Name | LOWELL WALLACE |
| Practice Address |
1120 E Main St Ste 24 Philadelphia MS 39350-2300 |
| Practice Telephone | 6017818677 |
| Practice Fax Number | 6012077720 |
| Mailing Telephone | 6017818677 |
| Mailing Fax Number | 6012077720 |
| Enumeration Date | 2017-10-20 |
| Last Update Date | 2018-03-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
Behavioral Health & Social Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 4715 24th Pl, Meridian, MS 393051686 | 6016966736 | 6016966778 |
| Street Address |
1120 E MAIN ST STE 24 |
| City | PHILADELPHIA |
| State | MS |
| Zip Code | 39350-2300 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952548646 | Kathy Gray | Counselor | 1120 E Main St Ste 24, Philadelphia, MS 39350-2300 | 2009-01-16 |
| 1881202182 | Tawana Gipson | Nurse Practitioner | 1120 E Main St Ste 24, Philadelphia, MS 39350-2300 | 2020-07-22 |
| 1790303816 | Comanechi Clayton | Nurse Practitioner | 1120 E Main St Ste 24, Philadelphia, MS 39350-2300 | 2020-07-07 |
| 1326687344 | Lakeeia Lashoundra Myles | Nurse Practitioner | 1120 E Main St Ste 24, Philadelphia, MS 39350-2300 | 2019-12-23 |
| 1275170300 | Aislin Boler | Counselor | 1120 E Main St Ste 24, Philadelphia, MS 39350-2300 | 2019-12-09 |
| 1679120190 | Skye Carlisle | Nurse Practitioner | 1120 E Main St Ste 24, Philadelphia, MS 39350-2300 | 2019-08-20 |
| 1225502412 | Sherita Danielle Wallace | Nurse Practitioner | 1120 E Main St Ste 24, Philadelphia, MS 39350 | 2019-01-22 |
| 1760963805 | Leah Rigney | Nurse Practitioner | 1120 E Main St Ste 24, Philadelphia, MS 39350-2300 | 2018-08-27 |
| 1245717685 | Intouch Health | Nurse Practitioner | 1120 E Main St Ste 24, Philadelphia, MS 39350-2300 | 2018-07-27 |
| 1588171128 | Stephanie Edwards | Nurse Practitioner | 1120 E Main St Ste 24, Philadelphia, MS 39350-2300 | 2018-01-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548817133 | Airpark Family Dentistry | Dentist | 1060 Holland Avenue, Philadelphia, MS 39350 | 2019-08-20 |
| 1396303962 | Medical Foundation Inc | Obstetrics & Gynecology | Rush Medical Group / Philadelphia, 1106 Central Drive, Ste 3, Philadelphia, MS 39350 | 2019-05-30 |
| 1144759580 | Mapp Home Care Services | In Home Supportive Care | 41 Eastover Dr, Philadelphia, MS 39350 | 2017-06-08 |
| 1710411707 | Rcg Mississippi, Inc. | Clinic/Center | 1100 Central Drive, Philadelphia, MS 39350 | 2017-04-17 |
| 1114339405 | Bernard Oneal | Adult Companion | 10090 Rd 0022, None, Philadelphia, MS 39350 | 2014-05-21 |
| 1417213323 | Region Ten Commision On Mental Health | Clinic/Center | 1011 Posey Avenue, Philadelphia, MS 39350 | 2012-04-04 |
| 1851427132 | Performance Therapy LLC | Physical Therapist | Performance Therapy, LLC, 921 W Beacon Street, Philadelphia, MS 39350 | 2007-02-23 |
| 1922161900 | Ernest Barton Cross | Audiologist | 1120 East Main Street, Suite 4, Philadelphia, MS 39350 | 2006-12-19 |
| 1649348129 | Augustus P Soriano | Family Medicine | 517 Center Avenue, Philadelphia, MS 39350 | 2006-12-01 |
| 1982777983 | Bill G Molpus | Dentist | 247 Byrd Ave, Philadelphia, MS 39350 | 2006-11-16 |
| Find all providers in zip 39350 | ||||
| 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 |
|---|---|---|---|---|
| 1215538657 | Noel Mitchell | Social Worker | 410 Memphis St, Philadelphia, PA 19125-2642 | 2020-11-03 |
| 1326649963 | Sarah Michelle Waxman | Social Worker | 2550 Grays Ferry Ave, Philadelphia, PA 19146-2331 | 2020-11-02 |
| 1467051540 | Maya Cox | Social Worker | 4045 Green St, Philadelphia, PA 19104-1759 | 2020-10-20 |
| 1679170575 | Wendy Diane Nickerson | Social Worker | 741 S 2nd St, Philadelphia, PA 19147-3425 | 2020-10-04 |
| 1497362404 | Lora M Rhodes | Social Worker | 925 Chestnut St Ste 321a, Philadelphia, PA 19107-4216 | 2020-09-24 |
| 1841806395 | Molly Vocino | Social Worker | 925 Chestnut St Ste 422u, Philadelphia, PA 19107-4216 | 2020-09-21 |
| 1306452065 | Rebecca Cammy | Social Worker | 925 Chestnut St # 422w, Philadelphia, PA 19107-4216 | 2020-09-18 |
| 1598378663 | Suzanne Banning Anderson | Social Worker | Sayre High School, 5800 Walnut St, Philadelphia, PA 19139 | 2020-08-28 |
| 1265045272 | Lisa Gabrielle Schilansky | Social Worker | 4813 Springfield Ave Apt 1, Philadelphia, PA 19143-3409 | 2020-08-28 |
| 1962015537 | Joanna Elizabeth Vanore | Social Worker | 4725 Sheldon St, Philadelphia, PA 19127-1008 | 2020-08-24 |
| Find all providers in PHILADELPHIA | ||||
| City | PHILADELPHIA |
| Zip Code | 39350 |
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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.