Active NPI
Joyce R Wallace, PHD
- Counseling Psychologist
- Blue Springs, MO
National Provider Identifier
1780725762
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counseling Psychologist
- License
- 01709
- Practice address
- 1200 NW South Outer Rd
Ste 310
Blue Springs, MO 64015-3072 - Phone
- (816) 224-0242
- Fax
- (816) 224-0454
- NPI assigned
- Feb 10, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counseling Psychologist | 103TC1900X | 01709 | MO | Primary |
Addresses
Primary practice location
1200 NW South Outer Rd
Ste 310
Blue Springs, MO 64015-3072
Mailing address
1200 NW South Outer Rd
Ste 310
Blue Springs, MO 64015-3072
Phone (816) 224-0242
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)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01709 | MO | MD | Counseling Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171065600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1780725762",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1200 NW SOUTH OUTER RD",
"address_2": "STE 310",
"city": "BLUE SPRINGS",
"state": "MO",
"postal_code": "640153072",
"telephone_number": "816-224-0242",
"fax_number": "816-224-0454"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1200 NW SOUTH OUTER RD",
"address_2": "STE 310",
"city": "BLUE SPRINGS",
"state": "MO",
"postal_code": "640153072",
"telephone_number": "816-224-0242",
"fax_number": "816-224-0454"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALLACE",
"first_name": "JOYCE",
"middle_name": "R",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-02-10",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC1900X",
"taxonomy_group": "",
"desc": "Psychologist, Counseling",
"state": "MO",
"license": "01709",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Blue Springs, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.