Individual provider Active NPI

Codi Labrina Wallace, LPC

  • Mental Health Counselor
  • Starkville, MS
National Provider Identifier
1992384432
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
2441 Issued in MS
Practice address
100 Starr Ave
Suite K
Starkville, MS 39759
Phone
(972) 898-2394
NPI assigned
Apr 2, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 2441 MS Primary

Addresses

Primary practice location

100 Starr Ave
Suite K
Starkville, MS 39759

Mailing address

7863 Seer Creek Road
Starkville, MS 39759
Phone (972) 898-2394

Other practice location 1

7863 Self Creek Rd
Starkville, MS 39759-5750
Phone (662) 617-9179

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
2441MSMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Starkville Wellness Group Mental Health CurrentSince May 1, 2022 Accepting new patients
Truecolors Counseling, LLC. Mental Health CurrentSince Feb 19, 2023 Accepting new patients

Locations

100 Starr Ave
Ste K
Starkville, MS 39759
Phone (662) 340-5947

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1617321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1992384432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7863 SEER CREEK ROAD",
            "city": "STARKVILLE",
            "state": "MS",
            "postal_code": "39759",
            "telephone_number": "972-898-2394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 STARR AVE",
            "address_2": "SUITE K",
            "city": "STARKVILLE",
            "state": "MS",
            "postal_code": "39759",
            "telephone_number": "972-898-2394"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7863 Self Creek Rd",
            "address_purpose": "LOCATION",
            "city": "Starkville",
            "state": "MS",
            "postal_code": "397595750",
            "country_code": "US",
            "telephone_number": "662-617-9179",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "CODI",
        "middle_name": "LABRINA",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-02",
        "last_updated": "2025-09-11",
        "certification_date": "2022-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MS",
            "license": "2441",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Starkville, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 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.