Donya Demesha Wallace, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

4697 Issued in SC

Practice address

201 Short St
Kingstree, SC 29556-3926

Phone

(842) 354-7324

Fax

(843) 354-6461

NPI assigned

Jul 25, 2006

Last updated

Jul 9, 2007By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Donya Wallace Counseling &Consulting LLC

  • Professional Counselor
  • Kingstree, SC
  • NPI 1033250634
  NPD (past) Authorized official

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1558384164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "992 JASMINE LN",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295018599",
            "telephone_number": "843-773-9649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 SHORT ST",
            "city": "KINGSTREE",
            "state": "SC",
            "postal_code": "295563926",
            "telephone_number": "842-354-7324",
            "fax_number": "843-354-6461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "DONYA",
        "middle_name": "DEMESHA",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-25",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "SC",
            "license": "4697",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "WP8972",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Uplift Dynamics LLC
• Nagasumanth Vemula, MD
• Samantha Jenkins Vereen, MASTERS
• Vital Aging of Williamsburg County, Inc.
• Frances Wadford, RN
• Lucius Franklin Wates, DMD
• Kelsey Watson, OTR/L
• Jamie Roberts Webb, LPN
• Joseph Edmund Whetsell, RESPIRATORY THERAPIS
• Madison Graham Wiggins, PA-C

• Professional Counselor in Kingstree, SC
• Providers in Kingstree, SC by specialty
• Professional Counselor in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.