Individual provider Active NPI

Tessa Walls, LCPC

  • Professional Counselor
  • Hagerstown, MD
National Provider Identifier
1255967576
Registry record updated Oct 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LC16481 Issued in MD
Practice address
20 W Washington St Ste 503
Hagerstown, MD 21740-4520
Phone
(410) 861-0175
NPI assigned
Mar 18, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 9, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X LC16481 MD Primary

Addresses

Primary practice location

20 W Washington St Ste 503
Hagerstown, MD 21740-4520

Mailing address

14513 Finch LN
Hancock, MD 21750-1703

Other practice location 1

14513 Finch Ln
Hancock, MD 21750-1703
Phone (410) 903-3895

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250728001094 DC Practitioner - Mental Health Counselor 6800303611 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LC16481MDMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PA Mental Health CurrentSince May 13, 2025 Accepting new patients

Locations

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

8300 Boone Blvd
Ste 500
Vienna, VA 22182
Phone (703) 884-2598

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1584489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759968000000",
    "number": "1255967576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14513 FINCH LN",
            "city": "HANCOCK",
            "state": "MD",
            "postal_code": "217501703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 W WASHINGTON ST STE 503",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217404520",
            "telephone_number": "410-861-0175"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14513 Finch Ln",
            "address_purpose": "LOCATION",
            "city": "Hancock",
            "state": "MD",
            "postal_code": "217501703",
            "country_code": "US",
            "telephone_number": "410-903-3895",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALLS",
        "first_name": "TESSA",
        "credential": "LCPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-03-18",
        "last_updated": "2025-10-09",
        "certification_date": "2025-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MD",
            "license": "LC16481",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hagerstown, MD

Sources for this page

Verify at the official NPI Registry.