Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. TIMOTHY WALLACE JR., EDD
Deactivated Sole ProprietorDR. TIMOTHY WALLACE JR., EDD is a Professional Counselor healthcare provider located in COLUMBUS, Ohio. NPI 1619527611 is deactivated in the NPPES registry. Verify at CMS.
Professional Counselor · COLUMBUS, OH
This NPI has been deactivated.
The record was deactivated on December 21, 2022.
Deactivated NPIs are no longer valid for billing or credentialing. The provider may have retired, changed practice status, or had their NPI administratively deactivated.
Verify current licensure status with the NPPES NPI Registry or the relevant state medical board before relying on this record.
Registration Details
- NPI Number
- 1619527611
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Sep 12, 2019 (3.2739726027397 yrs)
- Last Updated
- Jan 22, 2025
- Deactivated
- Dec 21, 2022
- License
-
E.2504990 (OH)
- Sole Proprietor
- Yes
Practice Information
- Address
-
580 S HIGH ST STE 220COLUMBUS, OH, 432155644Browse OH providers · Browse ZIP 43215
- Phone
- 6146257183
- Primary Specialty
-
Professional Counselor
101YP2500X
Other Professional Counselor Providers in COLUMBUS, OH
| Name | Credential | NPI |
|---|---|---|
| MS. DANUTA VANBEYSTERVELDT | PCC | 1780678474 |
| MARY BETH CHAMBERS-WOODS | LPC | 1578550315 |
| MR. WILLIAM LESSLER | MSED LPCC | 1700869211 |
| MR. EDWARD SCOTT DAGENFIELD | LICDC, LPC | 1083693238 |
| SHANNON NILAJA EVANS | LPCC-S | 1194767004 |
| MR. RONALD MARK FOX | MA LPCC | 1427091610 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.