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DAVID KEITH WALLIS
NPI 1134685167
Peer Specialist in Madison Heights, MI

Active since February 14, 2019
1400 E 12 MILE RD, MADISON HEIGHTS, MI 48071(248) 658-1116(248) 658-1120 Get Directions Write a Review

NPPES record last updated: February 14, 2019. Verified against the NPPES registry weekly; last sync: September 27, 2026.

About David Keith Wallis NPPES

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

DAVID KEITH WALLIS (NPI 1134685167) is an individual peer specialist in Madison Heights, Michigan and active in the NPI registry since February 2019.

NPPES Registry Identity

NPI1134685167
Entity TypeIndividualMale
Primary Taxonomy175T00000X
Provider Legal NameDAVID KEITH WALLIS
Location Address1400 E 12 MILE RDMadison Heights, MI 48071-2651
Mailing Address1400 E 12 Mile RdMadison Heights, MI 48071-2651 · (248) 658-1116 · Fax (248) 658-1120
Phone(248) 658-1116
Fax(248) 658-1120
Sole ProprietorNo
Enumeration DateFebruary 14, 2019
✔ NPI 1134685167 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPeer SpecialistOther Service Providers
Taxonomy Code175T00000X
Definition
Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.
1400 E 12 MILE RD, Madison Heights, MI 48071
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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.

TANJA DECARLO-JACKSON
Counselor (Addiction (Substance Use Disorder))
1400 E 12 MILE RD
MADISON HEIGHTS, MI 48071
Oakland County (248) 547-2223
JILLIAN PARNOS LPC, CAADC
Counselor
1400 E 12 MILE RD
MADISON HEIGHTS, MI 48071
Oakland County (248) 761-7992
SHARITA BROWN
Counselor
1400 E 12 MILE RD
MADISON HEIGHTS, MI 48071
Oakland County (248) 658-1116
DANIELLE LAWLESS
Counselor (Professional)
1400 E 12 MILE RD
MADISON HTS, MI 48071
Oakland County (248) 658-1116
MS. SUSANNE LATESSA LLMSW, MED, BSN, RN
Social Worker (Clinical)
1400 E 12 MILE RD
MADISON HEIGHTS, MI 48071
Oakland County (248) 658-1116
PREMIER SERVICES OF MICHIGAN, LLC
Clinic/Center (Methadone)
1400 E 12 MILE RD
MADISON HEIGHTS, MI 48071
Oakland County (248) 547-2223
MARK FRAS
Counselor (Addiction (Substance Use Disorder))
1400 E 12 MILE RD
MADISON HEIGHTS, MI 48071
Oakland County (248) 658-1116
MRS. KATHRYN KAY LEVENSON B.A., L.M.S.W.
Social Worker
1400 E 12 MILE RD
MADISON HEIGHTS, MI 48071
Oakland County (248) 658-1116

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 David Wallis's NPI number?

The NPI number for David Wallis is 1134685167. It was assigned to this individual provider in the NPPES registry on February 14, 2019.

Where is David Wallis located?

David Wallis practices at 1400 E 12 Mile Rd, Madison Heights, MI 48071. The listed phone number is (248) 658-1116.

What is David Wallis's specialty?

The primary specialty registered for this NPI is Peer Specialist with taxonomy code 175T00000X.

When was this NPI record last updated?

The NPPES record for David Wallis was last updated on February 14, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.