Suzanne Marie Wallace, M. ED

Primary specialty

CounselorTaxonomy code 101Y00000X

Practice address

180 Fairfield Ave
Bridgeport, CT 06604-4252

Phone

(203) 394-6529

NPI assigned

Dec 14, 2006

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Education

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

{
    "created_epoch": "1166054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1659433985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "239 EDWARD ST",
            "city": "FAIRFIELD",
            "state": "CT",
            "postal_code": "068246702",
            "telephone_number": "203-255-5882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 FAIRFIELD AVE",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066044252",
            "telephone_number": "203-394-6529"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "SUZANNE",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "M. ED",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Hagan Walker, DDS
• Sasha Walker
• Tiawuana V Walker
• Donna M Wallace, ARPN
• Eva Alicja Wallace, DNP
• Charmaine Ann Marie Wallen
• Kereen Semone Waller Simpson
• Nancy Wallick, CRNA
• Carol Ann Walsh, RN
• Carolyn Walsh, CPNP

• Counselor in Bridgeport, CT
• Providers in Bridgeport, CT by specialty
• Counselor in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.