Alison Quinn Wallace, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LPC008383 Issued in GA

Practice address

3 W Altman St
Statesboro, GA 30458-5212

Phone

(912) 764-2402

Fax

(912) 764-5561

NPI assigned

Aug 29, 2012

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1346198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548720000000",
    "number": "1679821201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 W ALTMAN ST",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304585212",
            "telephone_number": "912-764-2402",
            "fax_number": "912-764-5561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 W ALTMAN ST",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304585212",
            "telephone_number": "912-764-2402",
            "fax_number": "912-764-5561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "ALISON",
        "middle_name": "QUINN",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-29",
        "last_updated": "2019-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC008383",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jorie Walker
• Kelcie Walker, OT
• Miranda Christine Walker, PHARMD
• Roswell Lindsay Walker Jr., RPH
• Michael Shane Wall, D.M.D.
• Kenneth Brian Walton, MD
• Cody Robert Ward, PA
• Rebecca Hobbs Ward, R.N.
• Warren Marshall Ward, D.C.
• Shakayla Ware, LPC

• Professional Counselor in Statesboro, GA
• Providers in Statesboro, GA by specialty
• Professional Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2019; 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.