Gabriel Wallace, RBT

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

License

RBT-17-31096 Issued in IN

Practice address

1701 Library Blvd Ste a
Greenwood, IN 46142-1567

Phone

(317) 881-9923

NPI assigned

Mar 8, 2021

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

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.

• Collaborating for Kids, LLC

  • Clinical Psychologist
  • Greenwood, IN
  • NPI 1851626386
  NPD

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

{
    "created_epoch": "1615161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615161600000",
    "number": "1467047860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 LIBRARY BLVD STE A",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "461421567",
            "telephone_number": "317-881-9923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 LIBRARY BLVD STE A",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "461421567",
            "telephone_number": "317-881-9923"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1701 Library Blvd Ste A",
            "address_purpose": "LOCATION",
            "city": "Greenwood",
            "state": "IN",
            "postal_code": "461421567",
            "country_code": "US",
            "telephone_number": "317-881-9923",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "GABRIEL",
        "credential": "RBT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-08",
        "last_updated": "2021-03-08",
        "certification_date": "2021-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "IN",
            "license": "RBT-17-31096",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Douglas H Walker, DPT
• Matthew Ryan Walker, MD
• Phillip M Walker, MD
• Thomas Howard Walker, D.D.S.
• Jacob B Wall, PA-C
• Jennifer Brooke Wallem, OTR
• Janine Elise Wallick, NP
• Nicole Wallis
• Kerri Raye Walls, PT, CLT, LANA
• Laura Walradth

• Behavior Technician in Greenwood, IN
• Providers in Greenwood, IN by specialty
• Behavior Technician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2021; 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.