KELLY LOVE WALLACE M. ED.
NPI 1124675749
Counselor - Professional in Edmond, OK

Q: What is Kelly Wallace's NPI number?

The NPI number for Kelly Wallace is 1124675749. It was assigned to this individual provider in the NPPES registry on August 19, 2019.

Q: What is Kelly Wallace's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Kelly Wallace was last updated on August 27, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.

Active since August 19, 2019

2817 STONEBROOK RD, EDMOND, OK 73003(214) 600-3503 Get Directions Write a Review

NPPES record last updated: August 27, 2021. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Aug 27, 2021, Aug 19, 2019 (2 updates tracked since 2019).

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About Kelly Love Wallace M. Ed. NPPES

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

KELLY LOVE WALLACE M. ED. (NPI 1124675749) is an individual professional provider in Edmond, Oklahoma, licensed in Texas (77947) and active in the NPI registry since August 2019.

NPPES Registry Identity

NPI1124675749

Entity TypeIndividualFemale

Primary Taxonomy101YP2500X

Provider Legal NameKELLY LOVE WALLACECredential: M. ED.

Location Address2817 STONEBROOK RDEdmond, OK 73003-2105

Mailing Address2817 Stonebrook RdEdmond, OK 73003-2105 · (214) 600-3503

Phone(214) 600-3503

Sole ProprietorYes

Enumeration DateAugust 19, 2019

Last NPPES UpdateAugust 27, 20212 updates tracked since enumeration

NPPES CertifiedAugust 27, 2021

✔ NPI 1124675749 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 TX · 77947

2817 STONEBROOK RD, Edmond, OK 73003

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Texas, Medica, UnitedHealthcare.Insurance ›

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 Kelly Wallace's NPI number?

The NPI number for Kelly Wallace is 1124675749. It was assigned to this individual provider in the NPPES registry on August 19, 2019.

Where is Kelly Wallace located?

Kelly Wallace practices at 2817 Stonebrook Rd, Edmond, OK 73003. The listed phone number is (214) 600-3503.

What is Kelly Wallace's specialty?

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

What insurance does Kelly Wallace accept?

Health plans from Blue Cross and Blue Shield of Texas, Medica and UnitedHealthcare list Kelly Wallace as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Kelly Wallace was last updated on August 27, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.