AMANDA MARIE WALLACE (NPI# 1952808024) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1952808024 |
Entity Type | Individual |
Full Name | AMANDA MARIE WALLACE |
Credential | LCSW |
Practice Address |
205 Main St E Mohall ND 58761-4014 |
Mailing Address |
Po Box 305 Mohall ND 58761-0305 |
Practice Telephone | 7017566374 |
Mailing Telephone | 7017566374 |
Enumeration Date | 2018-04-06 |
Last Update Date | 2018-04-06 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 171M00000X | Case Manager/Care Coordinator | 4524 | ND | Other Service Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
ND | 1473894 | 05 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1518249838 | Amanda Daniel Wallace | Physician Assistant | 655 Jesse Jewell Pkwy Se Ste B, Gainesville, GA 30501-3854 | 2011-09-13 |
1366635245 | Amanda Wallace | Counselor | 1907 Kristy Ct, Longmont, CO 80504-7387 | 2007-08-23 |
1306345848 | Amanda Cheyenne Wallace | Student in an Organized Health Care Education/Training Program | 3640 Colonel Glenn Hwy, Dayton, OH 45435-0001 | 2018-02-11 |
1972015659 | Amanda Wallace | Behavior Technician | 41521 W 11 Mile Rd, Novi, MI 48375-1803 | 2017-11-02 |
1154844041 | Amanda Gail Wallace | Nurse Practitioner | 142 Depot Dr, South Shore, KY 41175-9306 | 2017-07-21 |
1578097341 | Amanda Wallace | Physical Therapist | 2115 Dulles Dr, Lafayette, LA 70506-2652 | 2017-04-18 |
1649665977 | Amanda Rose Wallace | Psychiatry & Neurology | 525 E 68th St, New York, NY 10065 | 2015-04-03 |
1972908010 | Amanda Jo Wallace | Psychologist | 1500 N Westwood Blvd, Poplar Bluff, MO 63901-3318 | 2014-10-31 |
1578964888 | Amanda Leigh Wallace | Speech-Language Pathologist | 928 W Market St, Tiffin, OH 44883-2529 | 2014-09-07 |
1053725952 | Amanda Wallace | Speech-Language Pathologist | 40w310 Lafox Rd, Suite A1/b1, St Charles, IL 60175-6588 | 2014-06-18 |
Street Address |
205 MAIN ST E |
City | MOHALL |
State | ND |
Zip Code | 58761-4014 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1295243277 | Renville County Social Services | Case Management | 205 Main St E, Mohall, ND 58761-4014 | 2018-01-12 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1003148644 | Melanie Ray Skar | Physical Medicine & Rehabilitation | 602 Main St. E, Good Samaritan Center, Mohall, ND 58761 | 2010-02-08 |
1154411676 | Mohall Ambulance Service | Ambulance | 105 Main St West, Mohall, ND 58761 | 2006-10-13 |
1114013604 | Theodore A Brown | Dentist | 106 3rd Ave Se, Mohall, ND 58761 | 2006-10-04 |
1033273339 | Paul Daniel Herigstad | Chiropractor | 202 5th St Nw, Mohall, ND 58761-0721 | 2006-12-20 |
1235730136 | Cindy Mae Anderson | Technician | 207 Central Ave S, Mohall, ND 58761-4066 | 2020-11-05 |
1861473852 | The Evangelical Lutheran Good Samaritan Society | Durable Medical Equipment & Medical Supplies | 602 Main St E, Mohall, ND 58761-4100 | 2005-11-08 |
1457717746 | Kayla Fisher | Speech-Language Pathologist | 602 Main St E, Mohall, ND 58761-4100 | 2016-01-04 |
1497138796 | Jan L Weathers | Community Health Worker | 602 Main St E, Mohall, ND 58761-4100 | 2015-07-04 |
1578761649 | Krista Hope Becker | Physical Therapist | 602 Main St E, Mohall, ND 58761-4100 | 2007-07-10 |
1184013047 | Virginia Jean Faulkner | Chiropractor | 101 Central Ave S, Ste 3, Mohall, ND 58761-4214 | 2015-01-15 |
Find all providers in zip 58761 |
Taxonomy Code | 171M00000X |
Grouping | Other Service Providers |
Classification | Case Manager/Care Coordinator |
A person who provides case management services and assists an individual in gaining access to needed medical, social, educational, and/or other services. The person has the ability to provide an assessment and review of completed plan of care on a periodic basis. This person is also able to take collaborative action to coordinate the services with other providers and monitor the enrollee’s progress toward the cost-effective achievement of objectives specified in the plan of care. Credentials may vary from an experience in the fields of psychology, social work, rehabilitation, nursing or a closely related human service field, to a related Assoc of Arts Degree or to nursing credentials. Some states may require certification in case management. |
Notes: Source: CMS State Medicaid Manual Section 4442.3 [7/1/2006: new] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1891300794 | Heather Leier | Case Manager/Care Coordinator | 101 16th St Sw, Minot, ND 58701-3463 | 2020-09-09 |
1659913879 | Christine Lawson | Case Manager/Care Coordinator | 531 W Villard St, Dickinson, ND 58601-5044 | 2019-10-09 |
1912549130 | Emily Gran | Case Manager/Care Coordinator | 531 W Villard St Ste 1, Dickinson, ND 58601-5044 | 2019-10-09 |
1821639899 | Brooke Peacock | Case Manager/Care Coordinator | 1008 4th Ave, Apt 116, Watford City, ND 58854-5885 | 2019-10-01 |
1104467174 | Fallon Kirby Maston | Case Manager/Care Coordinator | 1008 4th Ave Se Apt 116, Watford City, ND 58854-7732 | 2019-10-01 |
1942854260 | Johnita Whyte | Case Manager/Care Coordinator | 225 3rd St Se Fl 3, Minot, ND 58701-3958 | 2019-07-25 |
1225597750 | Missi Baranko | Case Manager/Care Coordinator | 4758 92nd Ave Sw, Richardton, ND 58652-9710 | 2019-03-14 |
1194216481 | Richard Yonick | Case Manager/Care Coordinator | South Central Human Service Center, 520 3rd St Nw, Jamestown, ND 58401 | 2018-05-23 |
1972092757 | William David Nix | Case Manager/Care Coordinator | 102 Main Ave W, Rolla, ND 58367 | 2018-05-07 |
1245748649 | Alissa Lynn Parsons | Case Manager/Care Coordinator | Chase Building, 2nd Floor, 516 Cooper Avenue, Grafton, ND 58237 | 2018-01-19 |
Find all providers with the same taxonomy |
Please comment or provide details below to improve the information on AMANDA MARIE 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.