LISA WALLACE LPC
NPI 1336779925
Counselor - Professional in Boulder, CO

Q: What is Lisa Wallace's NPI number?

The NPI number for Lisa Wallace is 1336779925. It was assigned to this individual provider in the NPPES registry on January 22, 2020.

Q: What is Lisa 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 Lisa Wallace was last updated on January 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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 January 22, 2020

2769 IRIS AVE STE 107, BOULDER, CO 80304(970) 368-9185 Get Directions Write a Review

NPPES record last updated: January 22, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Lisa Wallace Lpc NPPES

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

LISA WALLACE LPC (NPI 1336779925) is an individual professional provider in Boulder, Colorado, licensed in Colorado (0015978) and active in the NPI registry since January 2020.

NPPES Registry Identity

NPI1336779925

Entity TypeIndividualFemale

Primary Taxonomy101YP2500X

Provider Legal NameLISA WALLACECredential: LPC

Location Address2769 IRIS AVE STE 107Boulder, CO 80304-4405

Mailing Address1600 Bradley CtBoulder, CO 80305-7310 · (970) 389-3612

Phone(970) 368-9185

Sole ProprietorYes

Enumeration DateJanuary 22, 2020

✔ NPI 1336779925 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 CO · 0015978

2769 IRIS AVE STE 107, Boulder, CO 80304

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Other Identifiers 1

Other14607457CO · Caqh

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

OLIVER FRANKLIN MA, LPCC

Counselor (Mental Health)

2769 IRIS AVE STE 107
BOULDER, CO 80304

Boulder County (970) 680-3607

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 Lisa Wallace's NPI number?

The NPI number for Lisa Wallace is 1336779925. It was assigned to this individual provider in the NPPES registry on January 22, 2020.

Where is Lisa Wallace located?

Lisa Wallace practices at 2769 Iris Ave Ste 107, Boulder, CO 80304. The listed phone number is (970) 368-9185.

What is Lisa 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 Lisa Wallace was last updated on January 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.