Wallace Counseling, LLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

5913 Issued in CO

Legal business name

WALLACE COUNSELING, LLC

Practice address

4103 Boardwalk Dr Unit 202
Fort Collins, CO 80525-5930

Phone

(970) 817-4049

Fax

(877) 833-4460

NPI assigned

Sep 23, 2011

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Lisa M Wallace, MA, LPCNPI 1124002571

Title

Owner

Phone

(970) 817-4049

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CO

Enrollment records 1

Tax ID family

Wallace Counseling LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Wallace Counseling, LLC

  • Professional Counselor
  • Fort Collins, CO
  • NPI 1003271297
  NPD tax ID

Locations

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Wallace Counseling, LLC

  • Professional Counselor
  • Fort Collins, CO
  • NPI 1003271297
  NPPES parent name

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Lisa M Wallace, MA, LPC

  • Professional Counselor
  • Fort Collins, CO
  • NPI 1124002571
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1316736000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1760313600000",
    "number": "1396028544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 273338",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805273338",
            "telephone_number": "970-817-4049",
            "fax_number": "877-833-4460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4103 BOARDWALK DR UNIT 202",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805255930",
            "telephone_number": "970-817-4049",
            "fax_number": "877-833-4460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALLACE COUNSELING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-23",
        "last_updated": "2025-10-13",
        "certification_date": "2025-10-13",
        "status": "A",
        "authorized_official_last_name": "WALLACE",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "970-817-4049",
        "authorized_official_credential": "MA, LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": "CO",
            "license": "5913",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melanie Walker
• Rose Walker, M.A., LPC
• Milena Walkowiak, LPC, NCC
• Nikodem Walkowiak
• Wallace Counseling, LLC
• Anne Wallace, MD
• Lisa M Wallace, MA, LPC
• Susan Wallace, LPN
• Kathlene Sue Waller, M.D.
• Kristin Wallick, M.D.

• Professional Counselor in Fort Collins, CO
• Providers in Fort Collins, CO by specialty
• Professional Counselor in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.