Jennifer Laird Wallace, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

96257 Issued in TX

Practice address

106 E Milam St
Livingston, TX 77351-2936

Phone

(936) 215-1467

NPI assigned

Jun 19, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Serenity House Counseling, PLLCGroup PAC ID 3173973377, 11 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

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.

• Serenity House Counseling, PLLC

  • Professional Counselor
  • Livingston, TX
  • NPI 1568065142
  Medicare reassignment Care Compare group NPD
• Wallace Counseling Company PLLC

  • Professional Counselor
  • Livingston, TX
  • NPI 1528916228
  Medicare reassignment NPD Authorized official
• Sondermind Provider Network LLC

  • Clinical Social Worker
  • Denver, CO
  • NPI 1760854442

  TX

  Medicare reassignment

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

{
    "created_epoch": "1529366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784851200000",
    "number": "1497249882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 E MILAM ST",
            "city": "LIVINGSTON",
            "state": "TX",
            "postal_code": "773512936",
            "telephone_number": "936-933-9172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 E MILAM ST",
            "city": "LIVINGSTON",
            "state": "TX",
            "postal_code": "773512936",
            "telephone_number": "936-215-1467"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4468 Duff Rd",
            "address_purpose": "LOCATION",
            "city": "Livingston",
            "state": "TX",
            "postal_code": "773515627",
            "country_code": "US",
            "telephone_number": "936-215-1467",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1629 US Highway 190 E",
            "address_purpose": "LOCATION",
            "city": "Livingston",
            "state": "TX",
            "postal_code": "773514487",
            "country_code": "US",
            "telephone_number": "936-259-2119",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "JENNIFER",
        "middle_name": "LAIRD",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-19",
        "last_updated": "2026-07-24",
        "certification_date": "2026-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "96257",
            "primary": true
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "TX",
            "license": "330403",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Walgreen Co
• Frank Stephens Walker Jr., M.D.
• William Allan Wall, D.C.
• Wallace Counseling Company PLLC
• Wallace Place in the Pines
• Helen Wallington
• Walson, Inc,
• Beth-Michele Wargo, RN., CNM
• William E. Watson, O.D.
• Kumari K. Weeratunge, M.D.

• Professional Counselor in Livingston, TX
• Providers in Livingston, TX by specialty
• Professional Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2026; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.