Justine Alexandra Wall, M.S.

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

3474 Issued in NE

Practice address

1709 Jackson St
Omaha, NE 68102-2513

Phone

(402) 599-2551

NPI assigned

Apr 2, 2007

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1175472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663286400000",
    "number": "1376664284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1709 JACKSON STREET",
            "address_2": "OMAHA",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "68102",
            "telephone_number": "402-599-2551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1709 JACKSON ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681022513",
            "telephone_number": "402-599-2551"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "815 Dorcas St",
            "address_purpose": "LOCATION",
            "city": "Omaha",
            "state": "NE",
            "postal_code": "681081137",
            "country_code": "US",
            "telephone_number": "402-898-4135",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALL",
        "first_name": "JUSTINE",
        "middle_name": "ALEXANDRA",
        "name_prefix": "Ms.",
        "credential": "M.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-02",
        "last_updated": "2022-09-16",
        "certification_date": "2022-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NE",
            "license": "3474",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tyrese Walker
• Veronica Walker
• Vincent Walker Jr.
• Emily Wall, M.S.,CCC-SLP
• Heather A Wall, LIMHP, LMHP, LADC
• Amanda Wallace
• Anthony Nelson Wallace Jr.
• Beionka Wallace
• Brenda Wallace
• Dala Wallace

• Mental Health Counselor in Omaha, NE
• Providers in Omaha, NE by specialty
• Mental Health Counselor in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2022; 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.