Taylor Nicole Wallace

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Practice address

7104 Stratos LN
Gaithersburg, MD 20879-5425

Phone

(240) 672-4879

NPI assigned

Nov 14, 2021

Last updated

Nov 14, 2021By the provider in NPPES

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

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

{
    "created_epoch": "1636848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636848000000",
    "number": "1740946763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11870 GRAND PARK AVE APT 1000",
            "city": "NORTH BETHESDA",
            "state": "MD",
            "postal_code": "208528703",
            "telephone_number": "240-672-4879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7104 STRATOS LN",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208795425",
            "telephone_number": "240-672-4879"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5044 Dorsey Hall Dr Ste 204",
            "address_purpose": "LOCATION",
            "city": "Ellicott City",
            "state": "MD",
            "postal_code": "210427500",
            "country_code": "US",
            "telephone_number": "240-672-4879",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "TAYLOR",
        "middle_name": "NICOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-14",
        "last_updated": "2021-11-14",
        "certification_date": "2021-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jawanza Hakim Walker
• Kayla Walker
• Sydnee Walker, M.A.,LGPC,NCC
• Zayrikia Walker
• Alexis Walkins
• Natasha Samantha Walters
• Jane B. Walton, CMT
• Aifei Wang, LAC MAC
• Gexin Wang, CRNP-FAMILY
• Hang Wang, MD

• Clinical Social Worker in Gaithersburg, MD
• Providers in Gaithersburg, MD by specialty
• Clinical Social Worker in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 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.