NPIMap

Organization Active NPI

Wallace Counseling, LLC

  • Professional Counselor
  • Fort Collins, CO
National Provider Identifier
1003271297
Registry record updated Dec 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
5913 Issued in CO
Legal business name
WALLACE COUNSELING, LLC
Practice address
4115 Boardwalk Dr
Suite 200
Fort Collins, CO 80525-5945
Phone
(970) 817-4049
Fax
(877) 833-4460
NPI assigned
Dec 15, 2015
Organization subpart
Yes
Parent organization
WALLACE COUNSELING, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 15, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Lisa WallaceNPI 1124002571
Title
Owner
Phone
(970) 817-4049

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YP2500X 5913 CO Primary

Addresses

Primary practice location

4115 Boardwalk Dr
Suite 200
Fort Collins, CO 80525-5945

Mailing address

PO Box 273338
Fort Collins, CO 80527-3338
Phone (970) 817-4049

National Provider Directory

National Provider Directory
Tax ID family
Wallace Counseling LLC2 organizations share this tax ID, including this one
Part of
Wallace Counseling LLC

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1450137600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1450137600000",
    "number": "1003271297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 273338",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805273338",
            "telephone_number": "970-817-4049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4115 BOARDWALK DR",
            "address_2": "SUITE 200",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805255945",
            "telephone_number": "970-817-4049",
            "fax_number": "877-833-4460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALLACE COUNSELING, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WALLACE COUNSELING, LLC",
        "enumeration_date": "2015-12-15",
        "last_updated": "2015-12-15",
        "status": "A",
        "authorized_official_last_name": "WALLACE",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "970-817-4049"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": "CO",
            "license": "5913",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Collins, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.