Individual provider Active NPI

Dashawn LM Wallace, LPC

  • Professional Counselor
  • Canton, MI
National Provider Identifier
1730629973
Registry record updated Jun 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
170059 Issued in MI
Practice address
5840 N Canton Center Rd Ste 220
Canton, MI 48187-6717
Phone
(734) 999-0138
NPI assigned
Mar 7, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 170059 MI Primary

Addresses

Primary practice location

5840 N Canton Center Rd Ste 220
Canton, MI 48187-6717

Mailing address

5840 N Canton Center Rd Ste 220
Canton, MI 48187-6717
Phone (734) 999-0138

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
170059MIMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Dashawn Wallace Counseling, LLC Professional CurrentSince Jun 29, 2025 Accepting new patients

Locations

5840 N Canton Center Rd
Ste 220
Canton, MI 48187
Phone (734) 459-8050

13 N Washington St
Ypsilanti, MI 48197
Phone (734) 329-4620

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1488844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750723200000",
    "number": "1730629973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5840 N CANTON CENTER RD STE 220",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481876717",
            "telephone_number": "734-999-0138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5840 N CANTON CENTER RD STE 220",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481876717",
            "telephone_number": "734-999-0138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "DASHAWN",
        "middle_name": "LM",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-07",
        "last_updated": "2025-06-24",
        "certification_date": "2025-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "170059",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2025; 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.