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MELLANI MARITZA WALLACE
NPI 1033799499
Counselor in Brandon, MS

Active since April 10, 2021
613 MARQUETTE RD, BRANDON, MS 39042(601) 591-5553 Get Directions Write a Review

NPPES record last updated: April 10, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Mellani Maritza Wallace NPPES

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

MELLANI MARITZA WALLACE (NPI 1033799499) is an individual counselor in Brandon, Mississippi and active in the NPI registry since April 2021.

NPPES Registry Identity

NPI1033799499
Entity TypeIndividualFemale
Primary Taxonomy101Y00000X
Provider Legal NameMELLANI MARITZA WALLACE
Location Address613 MARQUETTE RDBrandon, MS 39042-3038
Mailing Address5749 Raymond Bolton RdBolton, MS 39041-9253 · (601) 968-7032
Phone(601) 591-5553
Sole ProprietorNo
Enumeration DateApril 10, 2021
NPPES CertifiedApril 10, 2021
✔ NPI 1033799499 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselorBehavioral Health & Social Service Providers
Taxonomy Code101Y00000X
Definition
A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.
613 MARQUETTE RD, Brandon, MS 39042
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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.

BRANDY NICOLE NEWSOME BYRD PMHNP-BC
Nurse Practitioner (Psychiatric/Mental Health)
613 MARQUETTE RD
BRANDON, MS 39042
Rankin County (601) 824-0342
EMILY LEE
Counselor (Mental Health)
613 MARQUETTE RD
BRANDON, MS 39042
Rankin County (601) 824-1692
SKY D DAVENPORT
Counselor (Mental Health)
613 MARQUETTE RD
BRANDON, MS 39042
Rankin County (601) 824-1692
TOMEKA LAFAWN BETHEA
Counselor (Mental Health)
613 MARQUETTE RD
BRANDON, MS 39042
Rankin County (601) 824-1692
BELINDA DAVIS
Counselor (Mental Health)
613 MARQUETTE RD
BRANDON, MS 39042
Rankin County (601) 824-1692
TALISA M COX
Counselor (Mental Health)
613 MARQUETTE RD
BRANDON, MS 39042
Rankin County (601) 824-1692
TAMEIKA M SMITH THERAPIST
Occupational Therapist (Mental Health)
613 MARQUETTE RD
BRANDON, MS 39042
Rankin County (601) 824-0342
RODGER WASSON JR.
Counselor (Mental Health)
613 MARQUETTE RD
BRANDON, MS 39042
Rankin County (601) 824-0342

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 Mellani Wallace's NPI number?

The NPI number for Mellani Wallace is 1033799499. It was assigned to this individual provider in the NPPES registry on April 10, 2021.

Where is Mellani Wallace located?

Mellani Wallace practices at 613 Marquette Rd, Brandon, MS 39042. The listed phone number is (601) 591-5553.

What is Mellani Wallace's specialty?

The primary specialty registered for this NPI is Counselor with taxonomy code 101Y00000X.

When was this NPI record last updated?

The NPPES record for Mellani Wallace was last updated on April 10, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.