Jennifer M. Wallace, M.ED

Primary specialty

Social WorkerTaxonomy code 104100000X

License

00561-A Issued in NV

Practice address

2298 W Horizon Ridge Pkwy
Suite 109
Henderson, NV 89052-2696

Phone

(702) 363-7284

Fax

(702) 242-5252

NPI assigned

May 4, 2007

Last updated

Sep 11, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Mrs. Geneva M. Wallace Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Education

State licenses

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

{
    "created_epoch": "1178236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1093927907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2298 W HORIZON RIDGE PKWY",
            "address_2": "SUITE 109",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890522696",
            "telephone_number": "702-363-7284",
            "fax_number": "702-242-5252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2298 W HORIZON RIDGE PKWY",
            "address_2": "SUITE 109",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890522696",
            "telephone_number": "702-363-7284",
            "fax_number": "702-242-5252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "JENNIFER",
        "middle_name": "M.",
        "name_prefix": "Mrs.",
        "credential": "M.ED",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-04",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NV",
            "license": "1118L",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NV",
            "license": "00561-A",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NV",
            "license": "R05387",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GENEVA",
            "last_name": "WALLACE",
            "middle_name": "M.",
            "prefix": "MRS.",
            "credential": "M.ED.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Tracey Walker
• Monica Jayne Wall, M.D.
• Robert W Wall
• Brooke Melanie Wallace, PA
• Jamie Wallace
• Trevor Wallace
• Barbara Wallen-Adams
• Carl Bradley Wallis, MD
• Jermaine Michael Walls, DDS
• Walmart Inc. (Walmart Pharmacy 10-2050)

• Social Worker in Henderson, NV
• Providers in Henderson, NV by specialty
• Social Worker in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 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.