Gloria Jean Waller, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

73537 Issued in TX

Practice address

1900 Denver Ave
El Paso, TX 79902-3008

Phone

(915) 544-2349

Fax

(915) 639-9532

NPI assigned

May 13, 2018

Last updated

Jun 5, 2020By 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 2

Addresses

Other names 1

• Ms. Gloria James Waller Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1526169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591315200000",
    "number": "1154811438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4365 LOMA ALEGRE DR",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799343766",
            "telephone_number": "915-328-2595",
            "fax_number": "915-639-9532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 DENVER AVE",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799023008",
            "telephone_number": "915-544-2349",
            "fax_number": "915-639-9532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLER",
        "first_name": "GLORIA",
        "middle_name": "JEAN",
        "name_prefix": "Ms.",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-13",
        "last_updated": "2020-06-05",
        "certification_date": "2020-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "TX",
            "license": "12881",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "73537",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GLORIA",
            "last_name": "WALLER",
            "middle_name": "JAMES",
            "prefix": "MS.",
            "credential": "LCDC",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Haley Elizabeth Wall, MS OTR/L
• Sofia Wall, SLP
• Alan James Wallace, MD
• Diane Wallace, SLP
• Imelda V Wallace, FNP-BC
• Mary A Walsh, MT
• Walter Lee Tippin,DDS, P.C
• Walter Tippin DDS Paul Apilado DDS Inc.
• Perri D Walter, LPC, LCDC
• Richard Sikuku Walulu, PHARMD

• Professional Counselor in El Paso, TX
• Providers in El Paso, TX by specialty
• Professional Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2020; 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.