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MR. TERRY EUGENE WALLACE CADC
NPI 1831304922
Counselor - Addiction (Substance Use Disorder) in Idabel, OK

Active since May 11, 2007
104 NE AVENUE A, IDABEL, OK 74745(580) 286-3301 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: October 04, 2026.

About Mr. Terry Eugene Wallace Cadc NPPES

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

MR. TERRY EUGENE WALLACE CADC (NPI 1831304922) is an individual addiction (substance use disorder) provider in Idabel, Oklahoma, licensed in Oklahoma (71) and active in the NPI registry since May 2007.

NPPES Registry Identity

NPI1831304922
Entity TypeIndividualMale
Primary Taxonomy101YA0400X
Provider Legal NameMR. TERRY EUGENE WALLACECredential: CADC
Location Address104 NE AVENUE AIdabel, OK 74745
Mailing AddressHc 73 Box 348Haworth, OK 74740-9515 · (580) 245-2990
Phone(580) 286-3301
Sole ProprietorYes
Enumeration DateMay 11, 2007
Last NPPES UpdateJuly 8, 2007
✔ NPI 1831304922 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers
Taxonomy Code101YA0400X
Licenses✔ Licensed in OK · 71✔ Licensed in OK · 9591601399✔ Licensed in OK · 558
104 NE AVENUE A, Idabel, OK 74745
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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 Terry Wallace's NPI number?

The NPI number for Terry Wallace is 1831304922. It was assigned to this individual provider in the NPPES registry on May 11, 2007.

Where is Terry Wallace located?

Terry Wallace practices at 104 NE Avenue A, Idabel, OK 74745. The listed phone number is (580) 286-3301.

What is Terry Wallace's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Addiction (Substance Use Disorder), with taxonomy code 101YA0400X.

When was this NPI record last updated?

The NPPES record for Terry Wallace was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.