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LA'TAJA WALLACE
NPI 1902351745
Case Manager/Care Coordinator in Gautier, MS

Active since August 22, 2016
3407 SHAMROCK CT, GAUTIER, MS 39553(228) 497-0690 Get Directions Write a Review

NPPES record last updated: August 22, 2016. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About La'taja Wallace NPPES

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

LA'TAJA WALLACE (NPI 1902351745) is an individual case manager/care coordinator provider in Gautier, Mississippi and active in the NPI registry since August 2016.

NPPES Registry Identity

NPI1902351745
Entity TypeIndividualFemale
Primary Taxonomy171M00000X
Provider Legal NameLA'TAJA WALLACE
Location Address3407 SHAMROCK CTGautier, MS 39553-5337
Mailing Address3407 Shamrock CtGautier, MS 39553-5337
Phone(228) 497-0690
Sole ProprietorNo
Enumeration DateAugust 22, 2016
✔ NPI 1902351745 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.
3407 SHAMROCK CT, Gautier, MS 39553
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Other Identifiers 1

Medicaid00018214MS

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.

MS. PEGGY LYNN FENDLEY M.ED.
Counselor (Mental Health)
3407 SHAMROCK CT
GAUTIER, MS 39553
Jackson County (228) 497-0690
SINGING RIVER SERVICES
Clinic/Center (Mental Health (Including Community Mental Health Center))
3407 SHAMROCK CT
GAUTIER, MS 39553
Jackson County (228) 497-0690
MRS. JODI LEIGHANN CARLISLE MS COUNSELING PSYCHO
Counselor (Mental Health)
3407 SHAMROCK CT
GAUTIER, MS 39553
Jackson County (228) 497-0690
LANESHA JOSHUA BSW
Case Manager/Care Coordinator
3407 SHAMROCK CT
GAUTIER, MS 39553
Jackson County (228) 497-0690
DANA WEEKS
Case Manager/Care Coordinator
3407 SHAMROCK CT
GAUTIER, MS 39553
Jackson County (228) 497-0690
HILARY LOUISE PENNELL B.S.
Case Manager/Care Coordinator
3407 SHAMROCK CT
GAUTIER, MS 39553
Jackson County (228) 497-0690
MS. ANGELA DENISE TOUCHET B.S.
Case Manager/Care Coordinator
3407 SHAMROCK CT
GAUTIER, MS 39553
Jackson County (228) 497-0690
VALENCIA HENDERSON
Counselor (Mental Health)
3407 SHAMROCK CT
GAUTIER, MS 39553
Jackson County (228) 497-0690

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 La'taja Wallace's NPI number?

The NPI number for La'taja Wallace is 1902351745. It was assigned to this individual provider in the NPPES registry on August 22, 2016.

Where is La'taja Wallace located?

La'taja Wallace practices at 3407 Shamrock Ct, Gautier, MS 39553. The listed phone number is (228) 497-0690.

What is La'taja Wallace's specialty?

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

When was this NPI record last updated?

The NPPES record for La'taja Wallace was last updated on August 22, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.