DEBRA J WALLACE PCC-S LICDC NPI 1619271228

NPI Information

NPI: 1619271228
Provider Name: DEBRA J WALLACE, PCC-S, LICDC
Classification: Counselor - 101YP2500X
Entity Type: Individual

Specialization: Professional

Address:
1207 W STATE ST
SUITE F
ALLIANCE, OH
ZIP 44601
Phone: (330) 821-3846
Get Directions

Debra J Wallace, PCC-S, LICDC is a professional counselor in Alliance, OH. Debra J Wallace, PCC-S, LICDC NPI is 1619271228. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1207 W STATE ST
SUITE F
ALLIANCE, OH
ZIP 44601-686
Phone: (330) 821-3846
Fax: (330) 821-5172

The enumeration date for this NPI number is 12/23/2010 and was last updated on 3/1/2017.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YA0400X	Counselor	Addiction (Substance Use Disorder)	LICDC.151044-CS	OHIO	No
2	101YP2500X	Counselor	Professional	E.0900224-SUPV	OHIO	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	0182777	MEDICAID	OHIO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

« Previous NPI

Next NPI »