Kelsey Wallace, LMT

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

7501007544 Issued in MI

Practice address

16500 Joy Rd # 258
Detroit, MI 48228-0632

Phone

(248) 417-5352

Fax

(888) 793-5313

NPI assigned

Feb 1, 2016

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Accident Recovery Therapeutic Massage LLC

  • Massage Therapist
  • Ypsilanti, MI
  • NPI 1649077116
  NPD Authorized official

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

{
    "created_epoch": "1454284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740873600000",
    "number": "1063870418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16500 JOY RD # 258",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482280632",
            "telephone_number": "248-417-5352",
            "fax_number": "888-793-5313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16500 JOY RD # 258",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482280632",
            "telephone_number": "248-417-5352",
            "fax_number": "888-793-5313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "KELSEY",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-02-01",
        "last_updated": "2025-03-02",
        "certification_date": "2025-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "MI",
            "license": "7501007544",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Denise Elizabeth Wallace, MA, LLP
• Inga Yvette Wallace
• Jaclyn Ann Wallace
• Jarred E Wallace, RN
• Kacie Wallace, M.S., PA-C
• Margaret L Wallace, PA
• Mercedes Wallace
• Priscilla Wallace
• Robert Jason Wallace, ATC
• Tiffany Astra Wallace, LLBSW

• Massage Therapist in Detroit, MI
• Providers in Detroit, MI by specialty
• Massage Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2025; 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.