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KEYONNA WALLACE
NPI 1861032864
Counselor - Addiction (Substance Use Disorder) in Kew Gardens, NY

Active since January 08, 2020
8002 KEW GARDENS RD STE 704, KEW GARDENS, NY 11415(718) 520-1513 Get Directions Write a Review

NPPES record last updated: October 19, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Oct 19, 2020, Jan 8, 2020 (2 updates tracked since 2020).

About Keyonna Wallace NPPES

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

KEYONNA WALLACE (NPI 1861032864) is an individual addiction (substance use disorder) provider in Kew Gardens, New York, licensed in New York (31387) and active in the NPI registry since January 2020. She maintains a secondary practice location in New York.

NPPES Registry Identity

NPI1861032864
Entity TypeIndividualFemale
Primary Taxonomy101YA0400X
Provider Legal NameKEYONNA WALLACE
Location Address8002 KEW GARDENS RD STE 704Kew Gardens, NY 11415-3607
Mailing Address79 Glenridge RdGlenville, NY 12302-4523
Phone(718) 520-1513
Sole ProprietorYes
Enumeration DateJanuary 8, 2020
Last NPPES UpdateOctober 19, 20202 updates tracked since enumeration
NPPES CertifiedOctober 19, 2020
✔ NPI 1861032864 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
License✔ Licensed in NY · 31387
8002 KEW GARDENS RD STE 704, Kew Gardens, NY 11415
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Secondary Practice Location 1

Location 1135 W 50th StNew York, NY 10020-1201 · Phone (212) 582-9100

Other Identifiers 1

Medicaid01420795NY

Other Providers at the Same Location NPPES 12

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

ETHEL SPEYERER RN
Counselor (Addiction (Substance Use Disorder))
8002 KEW GARDENS RD STE 704
KEW GARDENS, NY 11415
Queens County (518) 952-8408
NADIRA MAHABIR LMSW
Social Worker
8002 KEW GARDENS RD STE 704
KEW GARDENS, NY 11415
Queens County (718) 520-1513
MAXX MILLER LMSW
Counselor (Addiction (Substance Use Disorder))
8002 KEW GARDENS RD STE 704
KEW GARDENS, NY 11415
Queens County (718) 520-1513
JAMES BISHOP JR.
Counselor (Addiction (Substance Use Disorder))
8002 KEW GARDENS RD STE 704
KEW GARDENS, NY 11415
Queens County (718) 520-1513
GEORGINA CAMPOS
Counselor (Addiction (Substance Use Disorder))
8002 KEW GARDENS RD STE 704
KEW GARDENS, NY 11415
Queens County (718) 520-1513
MANDASIA ARROYO LMSW
Social Worker
8002 KEW GARDENS RD STE 704
KEW GARDENS, NY 11415
Queens County (718) 520-1513
HUI FANG ZHU MSW
Counselor (Addiction (Substance Use Disorder))
8002 KEW GARDENS RD STE 704
KEW GARDENS, NY 11415
Queens County (718) 520-1513
MILAGROS GOMEZ
Counselor (Addiction (Substance Use Disorder))
8002 KEW GARDENS RD STE 704
KEW GARDENS, NY 11415
Queens County (718) 520-1513

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 Keyonna Wallace's NPI number?

The NPI number for Keyonna Wallace is 1861032864. It was assigned to this individual provider in the NPPES registry on January 8, 2020.

Where is Keyonna Wallace located?

Keyonna Wallace practices at 8002 Kew Gardens Rd Ste 704, Kew Gardens, NY 11415. The listed phone number is (718) 520-1513.

What is Keyonna 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 Keyonna Wallace was last updated on October 19, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.