Lorraine Wallace

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

26NJ01106200 Issued in NJ

Practice address

259 Baldwin Rd Ste 203C
Parsippany, NJ 07054-7505

Phone

(973) 362-2091

NPI assigned

Jan 25, 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

Medicare fee-for-service enrollment

Enrolled in NJ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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

• Rest Assured Mental Health Wellness LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Parsippany, NJ
  • NPI 1184384836

  Single Specialty

  Medicare reassignment NPD Authorized official
• CPC Integrated Health, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Red Bank, NJ
  • NPI 1366497356

  Single Specialty

  Medicare reassignment NPD
• CPC Behavioral Healthcare, Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Matawan, NJ
  • NPI 1912036120

  Single Specialty

  NPD

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

{
    "created_epoch": "1611532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638316800000",
    "number": "1699365486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "259 BALDWIN RD STE 203C",
            "city": "PARSIPPANY",
            "state": "NJ",
            "postal_code": "070547505",
            "telephone_number": "733-622-0919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "259 BALDWIN RD STE 203C",
            "city": "PARSIPPANY",
            "state": "NJ",
            "postal_code": "070547505",
            "telephone_number": "973-362-2091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "LORRAINE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-01-25",
        "last_updated": "2021-12-01",
        "certification_date": "2021-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NJ",
            "license": "26NJ01106200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicole Lynn Vontell, COTA
• Walgreen Co
• Walk in Medical Care LLC
• Robert M Wall, MD
• Leona P. Butler Wallace
• Bailey Mitchell Walsh
• Erica Walters, M.D.
• Anne M Ward, RN
• Emily S Wardell, OTR
• Talmashia Warren

• Psychiatric/Mental Health Nurse Practitioner in Parsippany, NJ
• Providers in Parsippany, NJ by specialty
• Psychiatric/Mental Health Nurse Practitioner in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.