Cynthia C Wallace, MA, LCMHCS, NCC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

S6946 Issued in NC

Practice address

322 Lamar Ave Ste 209
Charlotte, NC 28204-2436

Phone

(704) 477-6044

NPI assigned

Oct 2, 2021

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

Electronic endpoints 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1633132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633132800000",
    "number": "1609548197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "322 LAMAR AVE STE 209",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282042436",
            "telephone_number": "704-477-6044",
            "fax_number": "704-477-6044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "322 LAMAR AVE STE 209",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282042436",
            "telephone_number": "704-477-6044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "CYNTHIA",
        "middle_name": "C",
        "credential": "MA, LCMHCS, NCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-10-02",
        "last_updated": "2021-10-02",
        "certification_date": "2021-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "S6946",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cindy@charlottecounselingandwellness.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "322 Lamar Ave Charlotte NC  28204",
            "address_1": "322 LaMar Ave Ste 209",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282042436",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cindy@charlottecounselingandwellness.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "mail",
            "address_1": "322 LaMar Ave Ste 209",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282042436",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Anya Wallace, PA-C
• Barbara Mary Wallace, LCSWA
• Caleb Wallace, DPT
• Chloe Wallace
• Courtni Wallace
• Dawn Spruill Wallace, DDS
• Devesdra Wallace
• James Lewis Wallace Jr., CPO
• James William Wallace, M.D.
• Jill Marie Wallace, N.P.

• Professional Counselor in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Professional Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2021; 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.