Nzuri Wallace, LADC/MH CANDIDATE

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

4130 N Lincoln Blvd
Oklahoma City, OK 73105-5209

Phone

(405) 267-3246

NPI assigned

Apr 20, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

Practice roles

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/HAGGAA

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.

• Covenant House California

  • Mental Illness Community Based Residential Treatment Facility
  • Los Angeles, CA
  • NPI 1518169325
  NPD (past)
• JWCH Institute, Inc

  dba JWCH Medical Clinic - Covenant House California

  • Community Health Clinic/Center
  • Los Angeles, CA
  • NPI 1528515152
  NPD (past)

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

{
    "created_epoch": "1271721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784246400000",
    "number": "1487970166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4130 N LINCOLN BLVD",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731055209",
            "telephone_number": "405-267-3246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4130 N LINCOLN BLVD",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731055209",
            "telephone_number": "405-267-3246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "NZURI",
        "credential": "LADC/MH CANDIDATE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-20",
        "last_updated": "2026-07-17",
        "certification_date": "2026-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "OK",
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OK",
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OK",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leslie Dawn Wallace
• Mark Wallace
• Marzette Wallace
• Melony Wallace
• Misty Wallace
• Rebecca Wallace
• Rebecca M Wallace, PSY.D.
• Tiara B Wallace
• Trenton Wallace
• William J Wallace Jr., DC

• Mental Health Counselor in Oklahoma City, OK
• Providers in Oklahoma City, OK by specialty
• Mental Health Counselor in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2026; 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.