Angela Nicole Wallace, MS, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

72163 Issued in TX

Practice address

5959 S Staples St
Suite 210
Corpus Christi, TX 78413-3845

Phone

(361) 991-3001

Fax

(361) 991-3002

NPI assigned

Feb 27, 2016

Last updated

Nov 17, 2022By 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

Enrolled in TX

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Deer Oaks Geriatric Services P C

  dba Deer Oaks Consultation Services

  • Clinical Psychologist
  • San Antonio, TX
  • NPI 1134169287
  Medicare reassignment NPD
• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  Professional, TX

  Medicare reassignment NPD
• Headlight Health Medical Group PLLC

  • Psychiatry Physician
  • San Diego, CA
  • NPI 1649064486
  NPD
• Deer Oaks Mental Health Associates PC

  • Clinical Psychologist
  • Las Cruces, NM
  • NPI 1134175763
  NPD (past)

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

{
    "created_epoch": "1456531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668643200000",
    "number": "1780044123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5959 S STAPLES ST",
            "address_2": "SUITE 210",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784133845",
            "telephone_number": "361-991-3001",
            "fax_number": "361-991-3002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5959 S STAPLES ST",
            "address_2": "SUITE 210",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784133845",
            "telephone_number": "361-991-3001",
            "fax_number": "361-991-3002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "ANGELA",
        "middle_name": "NICOLE",
        "name_prefix": "Mrs.",
        "credential": "MS, LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-27",
        "last_updated": "2022-11-17",
        "certification_date": "2022-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "72163",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katie Walker, COTA
• Patricia Walker, MSN FNP-BC
• Scott Gregory Walker, D.C.
• Shana Renee Walker, PT-ASSISTANT
• Tammy R Wall, PA-C
• Erin Lee Wallace
• Richard Wallach, DDS
• Maike Holleck Waller
• Charlotte Ann Walston, D.D.S.
• Shaye Lysette Walston, D.O.

• Professional Counselor in Corpus Christi, TX
• Providers in Corpus Christi, TX by specialty
• Professional Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.