Active NPI
Faith Ann Wallace, M.S., L.P.C.
- Professional Counselor
- Thornton, CO
National Provider Identifier
1184630196
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LPC.0015471
- Practice address
- 8931 Huron St
Thornton, CO 80260-6806 - Phone
- (303) 853-3500
- NPI assigned
- Jul 31, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 1980 | KS | |
| Mental Health Counselor | 101YM0800X | RC00055242 | WA | |
| Professional Counselor | 101YP2500X | LPC.0015471 | CO | Primary |
Addresses
Primary practice location
8931 Huron St
Thornton, CO 80260-6806
Mailing address
8931 Huron St
Thornton, CO 80260-6806
Phone (303) 853-3500
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RC00055242 | WA | MD | Mental Health Counselor |
| LPC.0015471 | CO | MD | Professional Counselor |
Interoperability endpoints
- faith.wallace.p2@direct.communityreachcenter.nextgenshare.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154304000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1562025600000",
"number": "1184630196",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8931 HURON ST",
"city": "THORNTON",
"state": "CO",
"postal_code": "802606806",
"telephone_number": "303-853-3500"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8931 HURON ST",
"city": "THORNTON",
"state": "CO",
"postal_code": "802606806",
"telephone_number": "303-853-3500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALLACE",
"first_name": "FAITH",
"middle_name": "ANN",
"credential": "M.S., L.P.C.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-31",
"last_updated": "2019-07-02",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "KS",
"license": "1980",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "WA",
"license": "RC00055242",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "CO",
"license": "LPC.0015471",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Thornton, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.