Jennifer Louise Wallace, CSW, QMHP

Primary specialty

Social WorkerTaxonomy code 104100000X

License

6674 Issued in SD

Practice address

851 West St
Rapid City, SD 57701-2516

Phone

(605) 393-4278

NPI assigned

Feb 6, 2019

Sex

Female

Sole proprietor

No

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Behavior Management Systems, Inc.

  • Community/Behavioral Health Agency
  • Rapid City, SD
  • NPI 1295878122
  NPD (past)

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

{
    "created_epoch": "1549411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757462400000",
    "number": "1174088900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24100 S ROCKERVILLE RD",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577027422",
            "telephone_number": "605-343-5422",
            "fax_number": "605-343-1411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "851 WEST ST",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577012516",
            "telephone_number": "605-393-4278"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5301 Hwy 16",
            "address_purpose": "LOCATION",
            "city": "Rapid City",
            "state": "SD",
            "postal_code": "57701",
            "country_code": "US",
            "telephone_number": "605-343-4278",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "24100 S Rockerville Rd",
            "address_purpose": "LOCATION",
            "city": "Rapid City",
            "state": "SD",
            "postal_code": "577027422",
            "country_code": "US",
            "telephone_number": "605-343-5422",
            "fax_number": "605-343-1411",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "JENNIFER",
        "middle_name": "LOUISE",
        "credential": "CSW, QMHP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-06",
        "last_updated": "2025-09-10",
        "certification_date": "2025-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "SD",
            "license": "6674",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James S Walder, MD
• Walgreen Co (Walgreens #10656)
• Walgreen Co (Walgreens #09512)
• Walgreen Co (Walgreens #05643)
• Walking in Grace Inc.
• Kimberly Anne Wallace
• William Chambers Waller Jr., M.D.
• Walmart Inc. (Walmart Pharmacy 10-1604)
• Walmart Inc. (WalMart Pharmacy 10-3872)
• Walmart Inc. (Walmart Vision Center 30-1604)

• Social Worker in Rapid City, SD
• Providers in Rapid City, SD by specialty
• Social Worker in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 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.