Stephanie Dawn Wallace, SW

Primary specialty

Social WorkerTaxonomy code 104100000X

Practice address

1203 Maple St
Greensboro, NC 27405-6910

Phone

(336) 641-6370

Fax

(336) 641-6693

NPI assigned

Apr 10, 2007

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": "1176163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1187827200000",
    "number": "1780807727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3900 SE WHISPERING WILLOWS DR",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274068599",
            "telephone_number": "336-641-6370",
            "fax_number": "336-641-6693"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1203 MAPLE ST",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274056910",
            "telephone_number": "336-641-6370",
            "fax_number": "336-641-6693"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "STEPHANIE",
        "middle_name": "DAWN",
        "name_prefix": "Mrs.",
        "credential": "SW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-10",
        "last_updated": "2007-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Catherine Lauren Wallace, D.O.
• Celeste Nicole Wallace, D.O.
• Erica Renee Wallace, D.O.
• Imani Wallace
• Sophia Pina Wallace
• Tiffany Wallace, DNP
• William Chase Wallen
• Chase Waller, DMD
• Wallflower Therapy
• Brandon Ladell Wallington

• Social Worker in Greensboro, NC
• Providers in Greensboro, NC by specialty
• Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 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.

Verify at the official NPI Registry.