Active NPI
Dionne Wallace
- Clinical Social Worker
- Lafayette, LA
National Provider Identifier
1487948568
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- IC-1329
- Practice address
- 1010 Auburn Ave
Lafayette, LA 70503-2308 - Phone
- (337) 261-2300
- Fax
- (337) 261-9080
- NPI assigned
- Jun 6, 2011
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | IC-1329 | NV | Primary |
Addresses
Primary practice location
1010 Auburn Ave
Lafayette, LA 70503-2308
Mailing address
1000 Chinaberry Dr Ste 900
Bossier City, LA 71111-2455
Phone (318) 459-6795
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NV
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230328001790 | NV | Practitioner - Clinical Social Worker | 1355715616 | Reassigns benefits to 3 organizations |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| IC-1329 | NV | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Behavioral Health Solutions LLC | Clinical | Current | Accepting new patients |
| Oasis Counseling LLC | Current | Accepting new patients | |
| Brightside Medical, P.C. | Current | Accepting new patients | |
| Next Level Psychiatry Arizona PLLC | Current | Accepting new patients | |
| Rehabilitation Services of Acadiana, LLC | Past | Accepting new patients |
Locations
2261 Market St
San Francisco, CA 94114
Phone (213) 337-4615
2360 W Horizon Ridge Pkwy
Ste 120
Henderson, NV 89052
Phone (702) 518-7629
2200 Paseo Verde Pkwy
Ste 190
Henderson, NV 89052
Phone (702) 483-5061
3172 N Rainbow Blvd
Las Vegas, NV 89108
Phone (702) 542-2277
Interoperability endpoints
- dionne.wallace.p1@direct.nevadahealthcenters.nextgenshare.com
Organizations & group practices 5
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.
-
- Community/Behavioral Health Agency
- Henderson, NV
- NPI 1548765258
Clinical, NV
-
- Psychiatry Physician
- Tucson, AZ
- NPI 1932703626
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Lafayette, LA
- NPI 1457686313
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1307318400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1717027200000",
"number": "1487948568",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1000 CHINABERRY DR STE 900",
"city": "BOSSIER CITY",
"state": "LA",
"postal_code": "711112455",
"telephone_number": "318-459-6795",
"fax_number": "318-626-5429"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1010 AUBURN AVE",
"city": "LAFAYETTE",
"state": "LA",
"postal_code": "705032308",
"telephone_number": "337-261-2300",
"fax_number": "337-261-9080"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALLACE",
"first_name": "DIONNE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-06-06",
"last_updated": "2024-05-30",
"certification_date": "2024-05-30",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NV",
"license": "IC-1329",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lafayette, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2024; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.