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TINA MARIE WALLIS LPC, CPCS
NPI 1063783462
Counselor - Professional in Dawsonville, GA

Active since January 18, 2012
12 WATERFRONT PARK CT, DAWSONVILLE, GA 30534(706) 490-9204 Get Directions Write a Review

NPPES record last updated: December 17, 2015. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Tina Marie Wallis Lpc, Cpcs NPPES

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

TINA MARIE WALLIS LPC, CPCS (NPI 1063783462) is an individual professional provider in Dawsonville, Georgia, licensed in Georgia (006897) and active in the NPI registry since January 2012.

NPPES Registry Identity

NPI1063783462
Entity TypeIndividualFemale
Primary Taxonomy101YP2500X
Provider Legal NameTINA MARIE WALLISCredential: LPC, CPCS
Location Address12 WATERFRONT PARK CTDawsonville, GA 30534-5772
Mailing Address12 Waterfront Park CtDawsonville, GA 30534-5772 · (706) 490-9204
Phone(706) 490-9204
Sole ProprietorNo
Enumeration DateJanuary 18, 2012
Last NPPES UpdateDecember 17, 2015
✔ NPI 1063783462 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
License✔ Licensed in GA · 006897
12 WATERFRONT PARK CT, Dawsonville, GA 30534
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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 Tina Wallis's NPI number?

The NPI number for Tina Wallis is 1063783462. It was assigned to this individual provider in the NPPES registry on January 18, 2012.

Where is Tina Wallis located?

Tina Wallis practices at 12 Waterfront Park Ct, Dawsonville, GA 30534. The listed phone number is (706) 490-9204.

What is Tina Wallis's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

When was this NPI record last updated?

The NPPES record for Tina Wallis was last updated on December 17, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.