KIMBERLY WALLACE LPC LLC
NPI 1659987238
Counselor - Professional in Marietta, GA
About Kimberly Wallace Lpc Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
KIMBERLY WALLACE LPC LLC (NPI 1659987238) is a healthcare organization registered as a professional in Marietta, Georgia and active in the NPI registry since September 2020. The organization lists Kimberly Wallace, Owner/provider, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Kimberly Wallace Lpc Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Kimberly Wallace Lpc LLC, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 Kimberly Wallace Lpc LLC's NPI number?
The NPI number for Kimberly Wallace Lpc LLC is 1659987238. It was assigned to this organization in the NPPES registry on September 19, 2020.
Where is Kimberly Wallace Lpc LLC located?
Kimberly Wallace Lpc LLC is located at 2852 Johnson Ferry Rd Ste 100, Marietta, GA 30062. The listed phone number is (404) 906-9831.
What is Kimberly Wallace Lpc LLC's specialty?
The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.
Is Kimberly Wallace Lpc LLC enrolled in Medicare?
Yes. Kimberly Wallace Lpc LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Kimberly Wallace Lpc LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Mental Health Counselor) reassigns their Medicare billing to Kimberly Wallace Lpc LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Kimberly Wallace Lpc LLC was last updated on November 24, 2023. 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.
# Kimberly Wallace Lpc Llc · NPI 1659987238
Professional organization in Marietta, Georgia. Organization record, active in the CMS NPPES registry since September 19, 2020.
## Identity
- **NPI:** 1659987238 (Entity type: Organization)
- **Enumerated:** September 19, 2020
- **Primary specialty:** Counselor - Professional · taxonomy 101YP2500X
- **Organization subpart:** No
- **Authorized official:** Kimberly Wallace, OWNER/PROVIDER
## Practice location
- **Address:** 2852 JOHNSON FERRY RD STE 100, Marietta, GA 30062-5686
- **Phone:** (404) 906-9831
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Mental Health Counselor) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** November 24, 2023
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Source: [NPI Profile](https://npiprofile.com/npi/1659987238) · Data from the CMS NPPES public registry.