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MS. AMANDA WALLACE MA, LPC
NPI 1366635245
Counselor - Professional in Longmont, CO

Active since August 23, 2007
1907 KRISTY CT, LONGMONT, CO 80504(303) 507-5210 Get Directions Write a Review

NPPES record last updated: August 23, 2007. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Ms. Amanda Wallace Ma, Lpc NPPES

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

MS. AMANDA WALLACE MA, LPC (NPI 1366635245) is an individual professional provider in Longmont, Colorado, licensed in Colorado (3502) and active in the NPI registry since August 2007.

NPPES Registry Identity

NPI1366635245
Entity TypeIndividualFemale
Primary Taxonomy101YP2500X
Provider Legal NameMS. AMANDA WALLACECredential: MA, LPC
Location Address1907 KRISTY CTLongmont, CO 80504-7387
Mailing Address1907 Kristy CtLongmont, CO 80504-7387 · (303) 507-5210
Phone(303) 507-5210
Sole ProprietorYes
Enumeration DateAugust 23, 2007
✔ NPI 1366635245 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 · 3502
1907 KRISTY CT, Longmont, CO 80504
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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 Amanda Wallace's NPI number?

The NPI number for Amanda Wallace is 1366635245. It was assigned to this individual provider in the NPPES registry on August 23, 2007.

Where is Amanda Wallace located?

Amanda Wallace practices at 1907 Kristy Ct, Longmont, CO 80504. The listed phone number is (303) 507-5210.

What is Amanda 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 Amanda Wallace was last updated on August 23, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.