Active NPI
Vanessa Esther Wallace, MSW, LSW
- Mental Health Counselor
- Williamstown, NJ
National Provider Identifier
1487230405
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 44SL06851200
- Practice address
- 209 W Lois Dr
Williamstown, NJ 08094-1331 - Phone
- (856) 986-7020
- NPI assigned
- Mar 21, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | |||
| Mental Health Counselor | 101YM0800X | 44SL06851200 | NJ | Primary |
Addresses
Primary practice location
209 W Lois Dr
Williamstown, NJ 08094-1331
Mailing address
209 W Lois Dr
Williamstown, NJ 08094-1331
Phone (856) 986-7020
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 44SL06851200 | NJ | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1616284800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1739145600000",
"number": "1487230405",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "209 W LOIS DR",
"city": "WILLIAMSTOWN",
"state": "NJ",
"postal_code": "080941331",
"telephone_number": "856-986-7020"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "209 W LOIS DR",
"city": "WILLIAMSTOWN",
"state": "NJ",
"postal_code": "080941331",
"telephone_number": "856-986-7020"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALLACE",
"first_name": "VANESSA",
"middle_name": "ESTHER",
"name_prefix": "Ms.",
"credential": "MSW, LSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-03-21",
"last_updated": "2025-02-10",
"certification_date": "2025-02-10",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NJ",
"license": "44SL06851200",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Williamstown, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.