Judith Margaret Campbell Wallace, M.S.

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

6110 Shallowford Rd
Suite B
Chattanooga, TN 37421-1894

Phone

(423) 509-4123

NPI assigned

Mar 10, 2010

Sex

Female

Sole proprietor

No

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

• Mrs. Margaret Campbell Wallace Professional name

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 7, 2017.

{
    "created_epoch": "1268179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1502064000000",
    "number": "1811210495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 S. PERIMETER PARK DRIVE",
            "address_2": "SUITE 210",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372114143",
            "telephone_number": "865-525-0391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6110 SHALLOWFORD RD",
            "address_2": "SUITE B",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374211894",
            "telephone_number": "423-509-4123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPBELL WALLACE",
        "first_name": "JUDITH",
        "middle_name": "MARGARET",
        "name_prefix": "Mrs.",
        "credential": "M.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-10",
        "last_updated": "2017-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARGARET",
            "last_name": "WALLACE",
            "middle_name": "CAMPBELL",
            "prefix": "MRS.",
            "credential": "M.S.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Cecelia Cameron, LMSW- LSSW
• Kellie Leeann Cameron, PHARM.D
• Alyssa Rene Camp, CF-SLP
• Pamela Nicole Camp, FNP-C
• Patricia Ruth Lee Camp, M.ED
• Althea Campbell, DO
• Angela B Campbell, R.N.
• Craig O'Neil Campbell, M.D.
• Douglas Lee Campbell, M.D.
• Ian R Campbell

• All providers in Chattanooga, TN
• Mental Health Counselor in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2017; 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.