DONYA DEMESHA WALLACE LPC NPI 1558384164

NPI Information

  • NPI: 1558384164
  • Provider Name: DONYA DEMESHA WALLACE, LPC
  • Classification: Counselor - 101YP2500X
  • Specialization: Professional
  • Entity Type: Individual
  • Address: 201 SHORT ST
    KINGSTREE, SC
    ZIP 29556
  • Phone: (842) 354-7324

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NPI Details

Donya Demesha Wallace, LPC is a professional counselor in Kingstree, SC. Donya Demesha Wallace, LPC NPI is 1558384164. 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:

201 SHORT ST
KINGSTREE, SC
ZIP 29556-926
Phone: (842) 354-7324
Fax: (843) 354-6461

The enumeration date for this NPI number is 7/25/2006 and was last updated on 7/9/2007.

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
1101YP2500XCounselorProfessional4697SOUTH CAROLINAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1WP8972MEDICAIDSOUTH CAROLINA

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: 3/30/2025

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