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DESIREE WALLACE
NPI 1104637461
Counselor - Addiction (Substance Use Disorder) in Baltimore, MD

Active since January 16, 2025
3310 EASTERN AVE, BALTIMORE, MD 21224(443) 708-5056 Get Directions Write a Review

NPPES record last updated: January 16, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Desiree Wallace NPPES

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

DESIREE WALLACE (NPI 1104637461) is an individual addiction (substance use disorder) provider in Baltimore, Maryland, licensed in Maryland (ADT2383) and active in the NPI registry since January 2025.

NPPES Registry Identity

NPI1104637461
Entity TypeIndividualFemale
Primary Taxonomy101YA0400X
Provider Legal NameDESIREE WALLACE
Location Address3310 EASTERN AVEBaltimore, MD 21224-4108
Mailing Address501 Saint Paul St Apt 1004Baltimore, MD 21202-2280
Phone(443) 708-5056
Sole ProprietorNo
Enumeration DateJanuary 16, 2025
NPPES CertifiedJanuary 16, 2025
✔ NPI 1104637461 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers
Taxonomy Code101YA0400X
License✔ Licensed in MD · ADT2383
3310 EASTERN AVE, Baltimore, MD 21224
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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.

BRIYANA K CLARKE
Counselor (Mental Health)
3310 EASTERN AVE
BALTIMORE, MD 21224
Baltimore City (917) 214-6536
MARCO BREWER
Peer Specialist
3310 EASTERN AVE
BALTIMORE, MD 21224
Baltimore City (443) 708-5056
MUKARAM SALAKO
Counselor (Addiction (Substance Use Disorder))
3310 EASTERN AVE
BALTIMORE, MD 21224
Baltimore City (443) 708-5056
MASADEY BLALOCK
Counselor (Mental Health)
3310 EASTERN AVE
BALTIMORE, MD 21224
Baltimore City (443) 202-7401
MS. ANGELA ROSE REMMERS ALCOHOL DRUG TRAINEE
Counselor
3310 EASTERN AVE
BALTIMORE, MD 21224
Baltimore City (443) 623-1541
MRS. TERESA N/A STREETER-BUSTER
Case Manager/Care Coordinator
3310 EASTERN AVE
BALTIMORE, MD 21224
Baltimore City (443) 708-5056
SAMONNE A WHITEHEAD MSW, ADT
Counselor
3310 EASTERN AVE
BALTIMORE, MD 21224
Baltimore City (443) 708-5056
MISS DONNA JACKSON MSW, CAC-AD
Social Worker
3310 EASTERN AVE
BALTIMORE, MD 21224
Baltimore City (667) 400-5428

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 Desiree Wallace's NPI number?

The NPI number for Desiree Wallace is 1104637461. It was assigned to this individual provider in the NPPES registry on January 16, 2025.

Where is Desiree Wallace located?

Desiree Wallace practices at 3310 Eastern Ave, Baltimore, MD 21224. The listed phone number is (443) 708-5056.

What is Desiree Wallace's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Addiction (Substance Use Disorder), with taxonomy code 101YA0400X.

When was this NPI record last updated?

The NPPES record for Desiree Wallace was last updated on January 16, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 months 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.