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KANISHIA WALLACE
NPI 1023413515
Counselor - Mental Health in Deerfield Beach, FL

Active since October 27, 2014
500 FAIRWAY DR STE 102, DEERFIELD BEACH, FL 33441(888) 880-9270 Get Directions Write a Review

NPPES record last updated: May 3, 2019. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Kanishia Wallace NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KANISHIA WALLACE (NPI 1023413515) is an individual mental health provider in Deerfield Beach, Florida and active in the NPI registry since October 2014.

NPPES Registry Identity

NPI1023413515
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameKANISHIA WALLACE
Location Address500 FAIRWAY DR STE 102Deerfield Beach, FL 33441-1817
Mailing Address500 Fairway Dr Ste 102Deerfield Beach, FL 33441-1817 · (888) 880-9270
Phone(888) 880-9270
Sole ProprietorNo
Enumeration DateOctober 27, 2014
Last NPPES UpdateMay 3, 2019
✔ NPI 1023413515 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
500 FAIRWAY DR STE 102, Deerfield Beach, FL 33441
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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MICHELLE ANN SOKOLOWSKI
Developmental Therapist
500 FAIRWAY DR STE 102
DEERFIELD BEACH, FL 33441
Broward County (888) 880-9270
YOLANDA JOHNSON
Developmental Therapist
500 FAIRWAY DR STE 102
DEERFIELD BCH, FL 33441
Broward County (888) 880-9270
RITA MARTINEZ MS, BCBA
Behavior Analyst
500 FAIRWAY DR STE 102
DEERFIELD BEACH, FL 33441
Broward County (877) 418-2978
AMANDA MICHELLE MARTINEZ
Behavior Technician
500 FAIRWAY DR STE 102
DEERFIELD BEACH, FL 33441
Broward County (888) 880-9270
SAMANTHA HOLSAPPLE
Behavior Technician
500 FAIRWAY DR STE 102
DEERFIELD BEACH, FL 33441
Broward County (888) 880-9270
JESSICA AYETIN
Behavior Technician
500 FAIRWAY DR STE 102
DEERFIELD BEACH, FL 33441
Broward County (877) 418-2978
RONNI JUSTIN IRVING
Behavior Technician
500 FAIRWAY DR STE 102
DEERFIELD BEACH, FL 33441
Broward County (954) 764-9529
VICTORIA IVY PRENATT
Behavior Technician
500 FAIRWAY DR STE 102
DEERFIELD BEACH, FL 33441
Broward County (877) 418-2978

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kanishia Wallace's NPI number?

The NPI number for Kanishia Wallace is 1023413515. It was assigned to this individual provider in the NPPES registry on October 27, 2014.

Where is Kanishia Wallace located?

Kanishia Wallace practices at 500 Fairway Dr Ste 102, Deerfield Beach, FL 33441. The listed phone number is (888) 880-9270.

What is Kanishia Wallace's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

When was this NPI record last updated?

The NPPES record for Kanishia Wallace was last updated on May 3, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.