FANNIE BEATRICE WALLACE LAC NPI 1730628074

NPI Information

NPI: 1730628074
Provider Name: FANNIE BEATRICE WALLACE, LAC
Classification: Counselor - 101YM0800X
Entity Type: Individual

Specialization: Mental Health

Address:
104 SONNET ST
HOT SPRINGS, AR
ZIP 71913
Phone: (501) 553-5539
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Fannie Beatrice Wallace, LAC is a mental health counselor in Hot Springs, AR. Fannie Beatrice Wallace, LAC NPI is 1730628074. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

104 SONNET ST
HOT SPRINGS, AR
ZIP 71913-437
Phone: (501) 553-5539

The enumeration date for this NPI number is 2/20/2017 and was last updated on 6/27/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101Y00000X	Counselor		A2005077	ARKANSAS	No
2	171M00000X	Case Manager/Care Coordinator				No
3	101YM0800X	Counselor	Mental Health	A2005077	ARKANSAS	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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