James Wallace, MA, THM, STM

Primary specialty

CounselorTaxonomy code 101Y00000X

Practice address

12801 Flushing Meadows Dr Ste 250
Saint Louis, MO 63131-1829

Phone

(314) 626-4774

NPI assigned

Apr 30, 2025

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Jim Wallace Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

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

{
    "created_epoch": "1745971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745971200000",
    "number": "1841088549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "854 WEATHERWOOD DR",
            "city": "MANCHESTER",
            "state": "MO",
            "postal_code": "630217144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12801 FLUSHING MEADOWS DR STE 250",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631311829",
            "telephone_number": "314-626-4774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "JAMES",
        "credential": "MA, THM, STM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-04-30",
        "last_updated": "2025-04-30",
        "certification_date": "2025-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JIM",
            "last_name": "WALLACE",
            "credential": "MA, THM, STM",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Darcie L Wallace, PA-C
• Erin Wallace
• Francene Wallace
• Gretchen Coleman Wallace, MS, RD, LD, CD
• Jacob Henry Wallace, MD
• Jorge Wallace, PLPC
• Joslyn Wallace
• Kaila Wallace, DOULA
• Keith Alan Wallace, BS PHARM
• Kelly A Wallace, CRNA

• Counselor in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Counselor in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2025; 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.