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CHANTEL LEE WALLACE
NPI 1669234308
Counselor - Mental Health in Blackfoot, ID

Active since January 29, 2024
581 N ASH ST, BLACKFOOT, ID 83221(208) 973-5077 Get Directions Write a Review

NPPES record last updated: January 29, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Chantel Lee Wallace NPPES

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

CHANTEL LEE WALLACE (NPI 1669234308) is an individual mental health provider in Blackfoot, Idaho, licensed in Idaho (LMSW-43731) and active in the NPI registry since January 2024.

NPPES Registry Identity

NPI1669234308
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameCHANTEL LEE WALLACE
Location Address581 N ASH STBlackfoot, ID 83221-2223
Mailing Address581 N Ash StBlackfoot, ID 83221-2223 · (208) 973-5077
Phone(208) 973-5077
Sole ProprietorYes
Enumeration DateJanuary 29, 2024
NPPES CertifiedJanuary 28, 2024
✔ NPI 1669234308 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
License✔ Licensed in ID · LMSW-43731
581 N ASH ST, Blackfoot, ID 83221
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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 Chantel Wallace's NPI number?

The NPI number for Chantel Wallace is 1669234308. It was assigned to this individual provider in the NPPES registry on January 29, 2024.

Where is Chantel Wallace located?

Chantel Wallace practices at 581 N Ash St, Blackfoot, ID 83221. The listed phone number is (208) 973-5077.

What is Chantel 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 Chantel Wallace was last updated on January 29, 2024. 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.