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SAMANTHA RENEE WALLACE MHA
NPI 1811857675
Counselor - Mental Health in Prestonsburg, KY

Active since November 14, 2025
104 S FRONT AVE, PRESTONSBURG, KY 41653(606) 886-8572 Get Directions Write a Review

NPPES record last updated: November 14, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Samantha Renee Wallace Mha NPPES

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

SAMANTHA RENEE WALLACE MHA (NPI 1811857675) is an individual mental health provider in Prestonsburg, Kentucky and active in the NPI registry since November 2025.

NPPES Registry Identity

NPI1811857675
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameSAMANTHA RENEE WALLACECredential: MHA
Location Address104 S FRONT AVEPrestonsburg, KY 41653-1614
Mailing Address104 S Front AvePrestonsburg, KY 41653-1614 · (606) 886-8572
Phone(606) 886-8572
Sole ProprietorNo
Enumeration DateNovember 14, 2025
NPPES CertifiedNovember 14, 2025
✔ NPI 1811857675 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
104 S FRONT AVE, Prestonsburg, KY 41653
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Other Providers at the Same Location NPPES 20

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

PETER SMITHWICK OLIVER MD
Psychiatry & Neurology (Child & Adolescent Psychiatry)
104 S FRONT AVE
PRESTONSBURG, KY 41653
Floyd County (606) 886-8572
PHILLIP CAUDILL
Counselor (Mental Health)
104 S FRONT AVE
PRESTONSBURG, KY 41653
Floyd County (606) 886-8572
RACHAEL WILLOUGHBY
Counselor (Mental Health)
104 S FRONT AVE
PRESTONSBURG, KY 41653
Floyd County (606) 886-8572
BRITTANY SANDERS
Counselor (Mental Health)
104 S FRONT AVE
PRESTONSBURG, KY 41653
Floyd County (606) 886-8572
DONNA CRIDER
Counselor (Mental Health)
104 S FRONT AVE
PRESTONSBURG, KY 41653
Floyd County (606) 886-8572
ANDREA HURLEY
Community Health Worker
104 S FRONT AVE
PRESTONSBURG, KY 41653
Floyd County (606) 886-8572
AMY KNOTT
Community Health Worker
104 S FRONT AVE
PRESTONSBURG, KY 41653
Floyd County (606) 886-8572
CHELSEA GOBLE
Counselor (Mental Health)
104 S FRONT AVE
PRESTONSBURG, KY 41653
Floyd County (606) 886-8572

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 Samantha Wallace's NPI number?

The NPI number for Samantha Wallace is 1811857675. It was assigned to this individual provider in the NPPES registry on November 14, 2025.

Where is Samantha Wallace located?

Samantha Wallace practices at 104 S Front Ave, Prestonsburg, KY 41653. The listed phone number is (606) 886-8572.

What is Samantha 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 Samantha Wallace was last updated on November 14, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 months 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.