DEEANDRIEZ WALLACE
NPI 1669113239
Counselor - Mental Health in Shreveport, LA

Q: What is Deeandriez Wallace's NPI number?

The NPI number for Deeandriez Wallace is 1669113239. It was assigned to this individual provider in the NPPES registry on April 6, 2022.

Q: What is Deeandriez Wallace's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Active since April 06, 2022

3003 KNIGHT ST, SUITE 115, SHREVEPORT, LA 71105(318) 614-7314 Get Directions Write a Review

NPPES record last updated: February 3, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Feb 3, 2023, Apr 26, 2022, Apr 6, 2022 (3 updates tracked since 2022).

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About Deeandriez Wallace NPPES

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

DEEANDRIEZ WALLACE (NPI 1669113239) is an individual mental health provider in Shreveport, Louisiana, licensed in Louisiana (PLC9016) and active in the NPI registry since April 2022.

NPPES Registry Identity

NPI1669113239

Entity TypeIndividualFemale

Primary Taxonomy101YM0800X

Provider Legal NameDEEANDRIEZ WALLACE

Location Address3003 KNIGHT ST, SUITE 115Shreveport, LA 71105-2561

Mailing Address3003 Knight St Ste 115Shreveport, LA 71105-2561

Phone(318) 614-7314

Sole ProprietorYes

Enumeration DateApril 6, 2022

Last NPPES UpdateFebruary 3, 20233 updates tracked since enumeration

NPPES CertifiedFebruary 3, 2023

✔ NPI 1669113239 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers

Taxonomy Code101YM0800X

License✔ Licensed in LA · PLC9016

Also ListedCase Manager/Care CoordinatorTaxonomy 171M00000X

3003 KNIGHT ST, Shreveport, LA 71105

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Other Providers at the Same Location NPPES 2

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

ST. GENEVIVE HEALTH CARE SERVICES, INC.

Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities

3003 KNIGHT ST, SUITE 123
SHREVEPORT, LA 71105

Caddo Parish (318) 219-4101

ASUM MEDICAL SUPPLY, INC.

Durable Medical Equipment & Medical Supplies

3003 KNIGHT ST, #149
SHREVEPORT, LA 71105

Caddo Parish (318) 862-2471

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 Deeandriez Wallace's NPI number?

The NPI number for Deeandriez Wallace is 1669113239. It was assigned to this individual provider in the NPPES registry on April 6, 2022.

Where is Deeandriez Wallace located?

Deeandriez Wallace practices at 3003 Knight St Suite 115, Shreveport, LA 71105. The listed phone number is (318) 614-7314.

What is Deeandriez Wallace's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

When was this NPI record last updated?

The NPPES record for Deeandriez Wallace was last updated on February 3, 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.