RAYCHELLE SHERYL WALLACE NPI 1609464098

NPI Information

  • NPI: 1609464098
  • Provider Name: RAYCHELLE SHERYL WALLACE
  • Classification: Counselor - 101YM0800X
  • Specialization: Mental Health
  • Entity Type: Individual
  • Address: 673 W LUMSDEN RD
    BRANDON, FL
    ZIP 33511
  • Phone: (813) 798-0800

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NPI Details

Raychelle Sheryl Wallace is a mental health counselor in Brandon, FL. Raychelle Sheryl Wallace NPI is 1609464098. 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:

673 W LUMSDEN RD
BRANDON, FL
ZIP 33511-911
Phone: (813) 798-0800
Fax: (813) 798-7800

The enumeration date for this NPI number is 1/2/2021 and was last updated on 8/14/2023.

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
1251S00000XCommunity/Behavioral HealthIMH18337FLORIDANo
2261QM0801XClinic/CenterMental Health (Including Community Mental Health Center)IMH18337FLORIDANo
3251B00000XCase ManagementIMH18337FLORIDANo
4261QM0850XClinic/CenterAdult Mental HealthIMH18337FLORIDANo
5261QM0855XClinic/CenterAdolescent and Children Mental HealthIMH18337FLORIDANo
6101YM0800XCounselorMental HealthMH19813FLORIDAYes

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: 11/21/2025

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