Aja Jeanette Wallace, LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MHC648 Issued in HI

Practice address

447 Mananai PL Apt T
Honolulu, HI 96818-1872

Phone

(808) 725-7519

NPI assigned

Jun 13, 2019

Sex

Female

Sole proprietor

Yes

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

Enrolled in HI

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Wellness Partners Hawaii Inc

  • Psychiatric/Mental Health Nurse Practitioner
  • Honolulu, HI
  • NPI 1609382340
  Medicare reassignment NPD
• Wellness Partners Hawaii PHP and Iop, LLC

  • Community/Behavioral Health Agency
  • Honolulu, HI
  • NPI 1033953922
  NPD

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

{
    "created_epoch": "1560384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684108800000",
    "number": "1306406228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "447 MANANAI PL APT T",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968181872",
            "telephone_number": "808-725-7519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "447 MANANAI PL APT T",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968181872",
            "telephone_number": "808-725-7519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "AJA",
        "middle_name": "JEANETTE",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-06-13",
        "last_updated": "2023-05-15",
        "certification_date": "2023-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "HI",
            "license": "MHC648",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thomas G. M. Walker, LMT
• Elizabeth Ann Wall, DNP, APNP, PMHNP-BC
• Stephen N Wall, MD
• Veronica Wallace-Cruz
• Ariel Wallace-Wong
• Haley Anne Wallace
• Victoria Lee Wallace
• Walmart Inc.
• Walmart Inc.
• Catherine P Walsh, PHD

• Mental Health Counselor in Honolulu, HI
• Providers in Honolulu, HI by specialty
• Mental Health Counselor in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.