PRISCILLA WALLACE


Address: 2051 W Grand Blvd, Detroit, MI 48208-1105
Phone: 3139613200

PRISCILLA WALLACE (NPI# 1962843417) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

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

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 1041C0700X Social Worker
Specialization: Clinical
6802086262 MI Behavioral Health & Social Service Providers

Other Providers PRISCILLA WALLACE

NPI Name Taxonomy Address Enumeration
1932210069 Priscilla Jane Wallace Radiology 233 Ne 102nd Ave, Portland, OR 97220 2006-08-31

Office Location

Street Address 2051 W GRAND BLVD
City DETROIT
State MI
Zip Code 48208-1105

Providers in the same location

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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Providers in the same zip code

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
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Taxonomy Information

Taxonomy Code 1041C0700X
Grouping Behavioral Health & Social Service Providers
Classification Social Worker
Specialization Clinical

Taxonomy Definition

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]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
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
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Competitor

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City DETROIT
Zip Code 48208

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Dataset Information

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.

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