Calvin Rainford Wallace

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LC15390 Issued in MD

Practice address

6500 Lake Park Dr Apt 103
Greenbelt, MD 20770-7001

Phone

(240) 535-3066

NPI assigned

Sep 25, 2025

Last updated

Sep 25, 2025By the provider in NPPES

Sex

Male

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

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": "1758758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758758400000",
    "number": "1316810385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6500 LAKE PARK DR APT 103",
            "city": "GREENBELT",
            "state": "MD",
            "postal_code": "207707001",
            "telephone_number": "240-535-3066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6500 LAKE PARK DR APT 103",
            "city": "GREENBELT",
            "state": "MD",
            "postal_code": "207707001",
            "telephone_number": "240-535-3066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "CALVIN",
        "middle_name": "RAINFORD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-09-25",
        "last_updated": "2025-09-25",
        "certification_date": "2025-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "MD",
            "license": "LC15390",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicoline Mukwei Wachu
• Nikiah Wade, LCPC
• Marcella Gordon Walder, MSW
• Danielle R Waldrop, M.D.
• Tonique Tanoya Walker
• Davina Wallace
• Quan Wang, M.D.
• Xiaoyan Wang, M.D.
• Marie L Warah
• Tynese D Ward

• Mental Health Counselor in Greenbelt, MD
• Providers in Greenbelt, MD by specialty
• Mental Health Counselor in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 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.