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MARK LYNN WALLACE JR.
NPI 1346198611
Peer Specialist in Tulsa, OK

Active since March 20, 2026
1728 S CARSON AVE, TULSA, OK 74119(918) 406-3420 Get Directions Write a Review

NPPES record last updated: April 3, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Apr 3, 2026, Mar 20, 2026 (2 updates tracked since 2026).

About Mark Lynn Wallace Jr. NPPES

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

MARK LYNN WALLACE JR. (NPI 1346198611) is an individual peer specialist in Tulsa, Oklahoma and active in the NPI registry since March 2026.

NPPES Registry Identity

NPI1346198611
Entity TypeIndividualMale
Primary Taxonomy175T00000X
Provider Legal NameMARK LYNN WALLACE JR.
Location Address1728 S CARSON AVETulsa, OK 74119-4610
Mailing Address2701 S Juniper Ave Apt 102Broken Arrow, OK 74012-7731 · (918) 888-0220
Phone(918) 406-3420
Sole ProprietorYes
Enumeration DateMarch 20, 2026
Last NPPES UpdateApril 3, 20262 updates tracked since enumeration
NPPES CertifiedApril 3, 2026
✔ NPI 1346198611 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.
1728 S CARSON AVE, Tulsa, OK 74119
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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.

DR. GARY RAYMOND RHODES JR. MA, MS, MMFT, DMIN
Marriage & Family Therapist
1728 S CARSON AVE
TULSA, OK 74119
Tulsa County (918) 406-3420
JIMMY DEAN HARJO JR.
Peer Specialist
1728 S CARSON AVE
TULSA, OK 74119
Tulsa County (918) 406-3420
MS. CINDY B SMITH M.S., L.P.C.
Counselor (Mental Health)
1728 S CARSON AVE
TULSA, OK 74119
Tulsa County (918) 816-1149
MR. CORY RAY THACKERAY
Peer Specialist
1728 S CARSON AVE
TULSA, OK 74119
Tulsa County (918) 946-1209
JOI-MICHELLE RHODES MSW
Social Worker (Clinical)
1728 S CARSON AVE
TULSA, OK 74119
Tulsa County (918) 936-6127
JOHNNIE FAYE LOONEY
Peer Specialist
1728 S CARSON AVE
TULSA, OK 74119
Tulsa County (918) 859-7510
JOHN JASON TAYLOR
Peer Specialist
1728 S CARSON AVE
TULSA, OK 74119
Tulsa County (918) 231-3887
ABRAXAS SCIENTIFIC
Clinical Medical Laboratory
1728 S CARSON AVE
TULSA, OK 74119
Tulsa County (918) 917-4321

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 Mark Wallace's NPI number?

The NPI number for Mark Wallace is 1346198611. It was assigned to this individual provider in the NPPES registry on March 20, 2026.

Where is Mark Wallace located?

Mark Wallace practices at 1728 S Carson Ave, Tulsa, OK 74119. The listed phone number is (918) 406-3420.

What is Mark Wallace'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 Mark Wallace was last updated on April 3, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.