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KIMBERLEY R WALLACE LCDC
NPI 1205677150
Counselor - Addiction (Substance Use Disorder) in Longview, TX

Active since June 04, 2024
107 WOODBINE PL, LONGVIEW, TX 75601(903) 758-2471(903) 234-1639 Get Directions Write a Review

NPPES record last updated: June 5, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Kimberley R Wallace Lcdc NPPES

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

KIMBERLEY R WALLACE LCDC (NPI 1205677150) is an individual addiction (substance use disorder) provider in Longview, Texas, licensed in Texas (17017) and active in the NPI registry since June 2024.

NPPES Registry Identity

NPI1205677150
Entity TypeIndividualFemale
Primary Taxonomy101YA0400X
Provider Legal NameKIMBERLEY R WALLACECredential: LCDC
Location Address107 WOODBINE PLLongview, TX 75601-2912
Mailing Address107 Woodbine PlLongview, TX 75601-2912 · (903) 758-2471 · Fax (903) 234-1639
Phone(903) 758-2471
Fax(903) 234-1639
Sole ProprietorYes
Enumeration DateJune 4, 2024
Last NPPES UpdateJune 5, 2024
NPPES CertifiedJune 5, 2024
✔ NPI 1205677150 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 TX · 17017
107 WOODBINE PL, Longview, TX 75601
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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.Insurance ›

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.

MEGAN BURCH LPC
Counselor (Professional)
107 WOODBINE PL
LONGVIEW, TX 75601
Gregg County (903) 758-2471
TAMMY WATSON-SMITH
Speech-Language Pathologist
107 WOODBINE PL
LONGVIEW, TX 75601
Gregg County (903) 237-2315
JUAN M SILOS LCDC
Counselor (Addiction (Substance Use Disorder))
107 WOODBINE PL
LONGVIEW, TX 75601
Gregg County (903) 758-2471
KIMBERLY L MABRY-PAROLINE APRN, NP-C,PMHNP-BC
Nurse Practitioner (Psychiatric/Mental Health)
107 WOODBINE PL
LONGVIEW, TX 75601
Gregg County (903) 758-2471
PATRICE L JERNEGONS LCDC
Counselor (Addiction (Substance Use Disorder))
107 WOODBINE PL
LONGVIEW, TX 75601
Gregg County (903) 758-2471
BEVERLY ANNE ABBOTT
Specialist
107 WOODBINE PL, UNIT 775
LONGVIEW, TX 75601
Gregg County (903) 237-2315
BERTHA ANN BURTON LCDC
Counselor (Addiction (Substance Use Disorder))
107 WOODBINE PL
LONGVIEW, TX 75601
Gregg County (903) 758-2471
MARNIE R ROOZEN L.P.C.
Counselor (Professional)
107 WOODBINE PL
LONGVIEW, TX 75601
Gregg County (903) 831-7585

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 Kimberley Wallace's NPI number?

The NPI number for Kimberley Wallace is 1205677150. It was assigned to this individual provider in the NPPES registry on June 4, 2024.

Where is Kimberley Wallace located?

Kimberley Wallace practices at 107 Woodbine Pl, Longview, TX 75601. The listed phone number is (903) 758-2471.

What is Kimberley Wallace's specialty?

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

What insurance does Kimberley Wallace accept?

Health plans from Blue Cross and Blue Shield of Texas list Kimberley 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 Kimberley Wallace was last updated on June 5, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.