EBONIE WALLACE - NPI 1871044255 - Case Manager/Care Coordinator in Daytona Beach, FL

Q: What is Ebonie Wallace's NPI number?

The NPI number for Ebonie Wallace is 1871044255. It was assigned to this individual provider in the NPPES registry on October 20, 2016.

Q: What is Ebonie Wallace's specialty?

The primary specialty registered for this NPI is Case Manager/Care Coordinator with taxonomy code 171M00000X.

Q: When was this NPI record last updated?

The NPPES record for Ebonie Wallace was last updated on February 18, 2021. NPI Profile syncs with the weekly NPPES data releases published by CMS.

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About Ebonie Wallace NPPES

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

EBONIE WALLACE (NPI 1871044255) is an individual case manager/care coordinator provider in Daytona Beach, Florida and active in the NPI registry since October 2016.

NPPES Registry Identity

NPI1871044255

Entity TypeIndividualFemale

Primary Taxonomy171M00000X

Provider Legal NameEBONIE WALLACE

Location Address140 S BEACH ST STE 310Daytona Beach, FL 32114-4409

Mailing Address140 S Beach StDaytona Beach, FL 32114-4472 · (386) 898-6040 · Fax (386) 256-2320

Phone(386) 898-6040

Fax(386) 256-2320

Sole ProprietorNo

Enumeration DateOctober 20, 2016

Last NPPES UpdateFebruary 18, 20212 updates tracked since enumeration

NPPES CertifiedFebruary 18, 2021

✔ NPI 1871044255 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCase Manager/Care CoordinatorOther Service Providers

Taxonomy Code171M00000X

Definition

A person who provides case management services and assists an individual in gaining access to needed medical, social, educational, and/or other services. The person has the ability to provide an assessment and review of completed plan of care on a periodic basis. This person is also able to take collaborative action to coordinate the services with other providers and monitor the enrollee's progress toward the cost-effective achievement of objectives specified in the plan of care. Credentials may vary from an experience in the fields of psychology, social work, rehabilitation, nursing or a closely related human service field, to a related Assoc of Arts Degree or to nursing credentials. Some states may require certification in case management.

140 S BEACH ST STE 310, Daytona Beach, FL 32114

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Other Identifiers 1

Medicaid019212700FL

Other Providers at the Same Location NPPES 19

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

MS. ROBIN WARRINGTON

Early Intervention Provider Agency