PRISCILLA WALLACE (NPI# 1962843417) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1962843417 |
Entity Type | Individual |
Full Name | PRISCILLA WALLACE |
Practice Address |
2051 W Grand Blvd Detroit MI 48208-1105 |
Practice Telephone | 3139613200 |
Mailing Telephone | 3139613200 |
Enumeration Date | 2013-07-12 |
Last Update Date | 2013-07-12 |
Gender Code | F |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 1041C0700X |
Social Worker Specialization: Clinical |
6802086262 | MI | Behavioral Health & Social Service Providers |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1932210069 | Priscilla Jane Wallace | Radiology | 233 Ne 102nd Ave, Portland, OR 97220 | 2006-08-31 |
Street Address |
2051 W GRAND BLVD |
City | DETROIT |
State | MI |
Zip Code | 48208-1105 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1871552463 | Lorraine Wagner Steele | Counselor | 2051 W Grand Blvd, Detroit, MI 48208-1105 | 2006-03-22 |
1407363294 | Louis Barry | Social Worker | 2051 W Grand Blvd, Detroit, MI 48208-1105 | 2018-01-03 |
1376059808 | Kevin Richmond | Counselor | 2051 W Grand Blvd, Detroit, MI 48208-1105 | 2017-12-20 |
1780100347 | Stephen Fano | Social Worker | 2051 W Grand Blvd, Detroit, MI 48208-1105 | 2017-08-16 |
1659892800 | Shalondia Aletia Ivey | Social Worker | 2051 W Grand Blvd, Detroit, MI 48208-1105 | 2017-06-28 |
1598286742 | Ted Edward Chaperon | Social Worker | 2051 W Grand Blvd, Detroit, MI 48208-1105 | 2017-06-28 |
1043731292 | Carolyn Lee Chambers | Social Worker | 2051 W Grand Blvd, Detroit, MI 48208-1105 | 2017-06-28 |
1497287924 | Tanya Bazile | Social Worker | 2051 W Grand Blvd, Detroit, MI 48208-1105 | 2017-04-03 |
1588195325 | Raymond Badejo | Registered Nurse | 2051 W Grand Blvd, Detroit, MI 48208-1105 | 2017-03-23 |
1861930018 | Deborah Scott | Counselor | 2051 W Grand Blvd, Detroit, MI 48208-1105 | 2017-02-08 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1023616554 | Henry Ford Health System | Pharmacy | 2800 W Grand Blvd, Detroit, MI 48208 | 2020-10-16 |
1932645405 | Diane Louise Dodson | Counselor | 5500 Trumbull Apt 315, Detroit, MI 48208 | 2017-01-09 |
1164881306 | Cory Eugene Martin | Counselor | 1852 W. Grand Blvd., Detroit, MI 48208 | 2016-02-16 |
1578947784 | Hamza Belhaj | Dentist | 2700 Martin Luther King Jr Blvd, Detroit, MI 48208 | 2015-07-17 |
1942629167 | Diana Pool | Counselor | 3737 Lawton, Detroit, MI 48208 | 2014-04-15 |
1124467048 | Aisha Williams | Social Worker | 4707 Vinewood St., Detroit, MI 48208 | 2013-06-25 |
1295079895 | Mia Love | Nurse Practitioner | 2959 Martin Luther King Jr Blvd, Detroit, MI 48208 | 2012-11-20 |
1992064356 | Valarie Egeria Foulks | Counselor | 2051 W. Grand Blvd, Detroit, MI 48208 | 2012-05-04 |
1023304078 | Ayana Njeri Davis | Massage Therapist | 2550 W. Grand Blvd, Detroit, MI 48208 | 2011-06-28 |
1184922627 | Shar Inc. | Community Based Residential Treatment Facility, Mental Illness | 1852 W.grand Blvd, Detroit, MI 48208 | 2011-03-08 |
Find all providers in zip 48208 |
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 |
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1457958811 | Jeana L Rooks | Social Worker | 19340 Riverview St, Detroit, MI 48219-4684 | 2020-10-07 |
1457966749 | Crystal Radford | Social Worker | 229 Riverside Dr, Detroit, MI 48215-3010 | 2020-09-13 |
1285248799 | Lachonta Alise Conley | Social Worker | 12594 Promenade St, Detroit, MI 48213-1416 | 2020-09-02 |
1780297754 | Simone D Yancy | Social Worker | 14247 Riverview St, Detroit, MI 48223-2414 | 2020-08-28 |
1104435460 | Goddess Great | Social Worker | 17163 E Warren Ave, Detroit, MI 48224-2279 | 2020-07-23 |
1710501689 | Matthew Vanderwindt | Social Worker | 3554 Yorkshire Rd, Detroit, MI 48224-2324 | 2020-06-05 |
1669091286 | Evan Theodore Fulford | Social Worker | 19928 Lichfield Rd, Detroit, MI 48221-1363 | 2020-04-14 |
1669001335 | Eric Allan Haynes | Social Worker | 1454 Strathcona Dr, Detroit, MI 48203-1464 | 2020-04-05 |
1629601729 | Stephanie Beaton | Social Worker | 3011 W Grand Blvd Ste 406, Detroit, MI 48202-3011 | 2020-02-17 |
1871125781 | Amalia S Miralrio | Social Worker | 1214 Griswold St Apt 805, Detroit, MI 48226-1816 | 2020-02-08 |
Find all providers in DETROIT |
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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.