Cynthia Wallace, PLMHP

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

11320 Issued in NE

Practice address

914 Baumann Dr
Grand Island, NE 68803-4401

Phone

(308) 385-5250

NPI assigned

Dec 12, 2017

Last updated

Dec 12, 2017By the provider in NPPES

Sex

Female

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

Enrolled in NE

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1513036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1513036800000",
    "number": "1528573524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "914 BAUMANN DR",
            "city": "GRAND ISLAND",
            "state": "NE",
            "postal_code": "688034401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "914 BAUMANN DR",
            "city": "GRAND ISLAND",
            "state": "NE",
            "postal_code": "688034401",
            "telephone_number": "308-385-5250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "CYNTHIA",
        "credential": "PLMHP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-12",
        "last_updated": "2017-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NE",
            "license": "11320",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amy J Walker, RD LMNT
• Jaycie Walker, PT, DPT
• Kelcey Walker, SLP
• Lauryn Taylor Walker, PLADC
• Debra Walkowiak
• Maria Wallace
• Paula Walling, RN
• Walmart Inc.
• Walmart Inc. (Walmart Pharmacy 10-3395)
• Mary Walsh-Sterup, OT

• Mental Health Counselor in Grand Island, NE
• Providers in Grand Island, NE by specialty
• Mental Health Counselor in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2017; 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.

Verify at the official NPI Registry.