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KERRIE WALLACE
NPI 1083161558
Counselor - Professional in Willis, TX

Active since September 01, 2016
12839 VIRGO DR, WILLIS, TX 77318(281) 799-5260 Get Directions Write a Review

NPPES record last updated: September 1, 2016. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Kerrie Wallace NPPES

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

KERRIE WALLACE (NPI 1083161558) is an individual professional provider in Willis, Texas, licensed in Texas (14980) and active in the NPI registry since September 2016.

NPPES Registry Identity

NPI1083161558
Entity TypeIndividualFemale
Primary Taxonomy101YP2500X
Provider Legal NameKERRIE WALLACE
Location Address12839 VIRGO DRWillis, TX 77318-5251
Mailing Address12839 Virgo DrWillis, TX 77318-5251 · (281) 799-5260
Phone(281) 799-5260
Sole ProprietorYes
Enumeration DateSeptember 1, 2016
✔ NPI 1083161558 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
License✔ Licensed in TX · 14980
Also ListedCounselor · Addiction (Substance Use Disorder)Taxonomy 101YA0400X · License 7693 (TX)
12839 VIRGO DR, Willis, TX 77318
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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 Kerrie Wallace's NPI number?

The NPI number for Kerrie Wallace is 1083161558. It was assigned to this individual provider in the NPPES registry on September 1, 2016.

Where is Kerrie Wallace located?

Kerrie Wallace practices at 12839 Virgo Dr, Willis, TX 77318. The listed phone number is (281) 799-5260.

What is Kerrie Wallace'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 Kerrie Wallace was last updated on September 1, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.