Abby Wallace, LAPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

APC003548 Issued in GA

Practice address

1875 Fant Dr
Fort Oglethorpe, GA 30742-3307

Phone

(706) 806-1169

Fax

(706) 806-1186

NPI assigned

Nov 8, 2012

Sex

Female

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

Enrolled in TN

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

Specialty

Mental Health Counselor

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

The Transformation CenterGroup PAC ID 6800137209, 8 clinicians

Practice addresses (Care Compare)

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.

• The Transformation Center

  • Professional Counselor
  • Chattanooga, TN
  • NPI 1518117597
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1352332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352332800000",
    "number": "1376897694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1875 FANT DR",
            "city": "FORT OGLETHORPE",
            "state": "GA",
            "postal_code": "307423307",
            "telephone_number": "706-806-1169",
            "fax_number": "706-806-1186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1875 FANT DR",
            "city": "FORT OGLETHORPE",
            "state": "GA",
            "postal_code": "307423307",
            "telephone_number": "706-806-1169",
            "fax_number": "706-806-1186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "ABBY",
        "credential": "LAPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-08",
        "last_updated": "2012-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "APC003548",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wal-Mart Stores East, LP
• Lukas Alexander Walden, LMFT
• Walgreen Co
• Walgreen Co
• Craig W Walker, DMD
• April Wash, COTA
• Amanda Webb
• Emily Webb, LCSW
• Lucyna Anne Webb, PHARMD
• Thomas Darrell Weldon, M.D.

• Professional Counselor in Fort Oglethorpe, GA
• Providers in Fort Oglethorpe, GA by specialty
• Professional Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2012; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.