Deborah Wallis, LAC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

A0302010 Issued in AR

Practice address

1575 Highway 371 W
Nashville, AR 71852-7598

Phone

(870) 451-9742

Fax

(870) 451-9752

NPI assigned

Apr 11, 2007

Last updated

Jul 8, 2007By 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 AR

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

Specialty

Mental Health Counselor

Education

Other, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Cornerstone Counseling Clinic, Inc.Group PAC ID 0547665382, 14 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Cornerstone Counseling Clinic, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Nashville, AR
  • NPI 1851819544
  Medicare reassignment Care Compare group NPD
• Teaxarkana Behavioral Associates, LC

  dba Vista Health Nashville

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Nashville, AR
  • NPI 1891950333
  NPD (past)

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

{
    "created_epoch": "1176249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1790908374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "127 WOODRUFF LN",
            "city": "NASHVILLE",
            "state": "AR",
            "postal_code": "718527542",
            "telephone_number": "870-557-1094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1575 HIGHWAY 371 W",
            "city": "NASHVILLE",
            "state": "AR",
            "postal_code": "718527598",
            "telephone_number": "870-451-9742",
            "fax_number": "870-451-9752"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLIS",
        "first_name": "DEBORAH",
        "credential": "LAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AR",
            "license": "A0302010",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alleigh Tucker
• Roberto Velasco
• Cynthia Villeda
• Amber Wagner, MS-CCC-SLP
• Regan Wakefield
• Elizabeth Leanne Wallis, APN
• Linzi Wallis
• Walmart Inc. (Walmart Pharmacy 10-0033)
• Annette Fay Wannamaker, LPN
• Jane A. Watts, O.T.R./L

• Mental Health Counselor in Nashville, AR
• Providers in Nashville, AR by specialty
• Mental Health Counselor in Arkansas

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.