Phillip Walleck, PHD

Primary specialty

Pastoral CounselorTaxonomy code 101YP1600X

Practice address

174 Watercolor Way # 103-238
Santa Rosa Beach, FL 32459-7350

Phone

(850) 660-8353

NPI assigned

Sep 11, 2024

Sex

Male

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

Credentials

Doctor of Philosophy

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.

• The Hope Center- Counseling

  • Pastoral Counselor
  • Santa Rosa Beach, FL
  • NPI 1942036355
  NPD

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

{
    "created_epoch": "1726012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726012800000",
    "number": "1346076767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "174 WATERCOLOR WAY # 103-238",
            "city": "SANTA ROSA BEACH",
            "state": "FL",
            "postal_code": "324597350",
            "telephone_number": "850-660-8353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "174 WATERCOLOR WAY # 103-238",
            "city": "SANTA ROSA BEACH",
            "state": "FL",
            "postal_code": "324597350",
            "telephone_number": "850-660-8353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLECK",
        "first_name": "PHILLIP",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-09-11",
        "last_updated": "2024-09-11",
        "certification_date": "2024-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP1600X",
            "taxonomy_group": "",
            "desc": "Counselor, Pastoral",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tiffany Laine Vroon, M.D.
• Kyle William Wagner, MSW
• Wal-Mart Stores East , LP
• Wal-Mart Stores East LP
• Lindsay Walleck, LPC, LMHC
• Jessica Lindsey Ward, OTA
• Leighann Ward
• Waterside Chiropractic Inc.
• Jennifer Weaver
• Lacy Renae Weeks

• Pastoral Counselor in Santa Rosa Beach, FL
• Providers in Santa Rosa Beach, FL by specialty
• Pastoral Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2024; 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.