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QUENTIN WALLACE
NPI 1558057372
Case Manager/Care Coordinator in Jackson, MS

Active since April 14, 2023
4780 I 55 FRONTAGE RD N STE 105, JACKSON, MS 39211(601) 956-4816(601) 956-4817 Get Directions Write a Review

NPPES record last updated: April 14, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Quentin Wallace NPPES

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

QUENTIN WALLACE (NPI 1558057372) is an individual case manager/care coordinator provider in Jackson, Mississippi and active in the NPI registry since April 2023.

NPPES Registry Identity

NPI1558057372
Entity TypeIndividualMale
Primary Taxonomy171M00000X
Provider Legal NameQUENTIN WALLACE
Location Address4780 I 55 FRONTAGE RD N STE 105Jackson, MS 39211-5542
Mailing Address4780 I 55 Frontage Rd N Ste 105Jackson, MS 39211-5542 · (601) 956-4816 · Fax (601) 956-4817
Phone(601) 956-4816
Fax(601) 956-4817
Sole ProprietorNo
Enumeration DateApril 14, 2023
NPPES CertifiedApril 14, 2023
✔ NPI 1558057372 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCase Manager/Care CoordinatorOther Service Providers
Taxonomy Code171M00000X
Definition
A person who provides case management services and assists an individual in gaining access to needed medical, social, educational, and/or other services. The person has the ability to provide an assessment and review of completed plan of care on a periodic basis. This person is also able to take collaborative action to coordinate the services with other providers and monitor the enrollee's progress toward the cost-effective achievement of objectives specified in the plan of care. Credentials may vary from an experience in the fields of psychology, social work, rehabilitation, nursing or a closely related human service field, to a related Assoc of Arts Degree or to nursing credentials. Some states may require certification in case management.
4780 I 55 FRONTAGE RD N STE 105, Jackson, MS 39211
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Other Providers at the Same Location NPPES 16

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

SHANDA RUSSELL
Counselor (Mental Health)
4780 I 55 FRONTAGE RD N STE 105
JACKSON, MS 39211
Hinds County (601) 956-4816
CANAKEEYA CONLEY
Case Manager/Care Coordinator
4780 I 55 FRONTAGE RD N STE 105
JACKSON, MS 39211
Hinds County (601) 956-4816
SHAKAYLIA TRIPLETT
Case Manager/Care Coordinator
4780 I 55 FRONTAGE RD N STE 105
JACKSON, MS 39211
Hinds County (601) 956-4816
EBONY NEWMAN
Case Manager/Care Coordinator
4780 I 55 FRONTAGE RD N STE 105
JACKSON, MS 39211
Hinds County (601) 956-4816
SHANNON FLOWERS
Counselor (Mental Health)
4780 I 55 FRONTAGE RD N STE 105
JACKSON, MS 39211
Hinds County (601) 956-4816
CHRISTIE SHARP
Case Manager/Care Coordinator
4780 I 55 FRONTAGE RD N STE 105
JACKSON, MS 39211
Hinds County (601) 956-4816
MARY HATHORN MS
Counselor (Mental Health)
4780 I 55 FRONTAGE RD N STE 105
JACKSON, MS 39211
Hinds County (601) 956-4816
BRIANNA HOLLEY
Case Manager/Care Coordinator
4780 I 55 FRONTAGE RD N STE 105
JACKSON, MS 39211
Hinds County (601) 956-4816

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 Quentin Wallace's NPI number?

The NPI number for Quentin Wallace is 1558057372. It was assigned to this individual provider in the NPPES registry on April 14, 2023.

Where is Quentin Wallace located?

Quentin Wallace practices at 4780 I 55 Frontage Rd N Ste 105, Jackson, MS 39211. The listed phone number is (601) 956-4816.

What is Quentin Wallace's specialty?

The primary specialty registered for this NPI is Case Manager/Care Coordinator with taxonomy code 171M00000X.

When was this NPI record last updated?

The NPPES record for Quentin Wallace was last updated on April 14, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.