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MRS. BONITA LUCILLE WALLACE LPC
NPI 1912364787
Counselor - Professional in Atlanta, GA

Active since January 25, 2016
550 PHARR RD NE, SUITE 605, ATLANTA, GA 30305(404) 664-6398(678) 705-2758 Get Directions Write a Review

NPPES record last updated: January 25, 2016. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Mrs. Bonita Lucille Wallace Lpc NPPES

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

MRS. BONITA LUCILLE WALLACE LPC (NPI 1912364787) is an individual professional provider in Atlanta, Georgia, licensed in Georgia (1823) and active in the NPI registry since January 2016.

NPPES Registry Identity

NPI1912364787
Entity TypeIndividualFemale
Primary Taxonomy101YP2500X
Provider Legal NameMRS. BONITA LUCILLE WALLACECredential: LPC
Location Address550 PHARR RD NE, SUITE 605Atlanta, GA 30305-3428
Mailing Address550 Pharr Rd Ne, Suite 605Atlanta, GA 30305-3428 · (404) 664-6398 · Fax (678) 705-2758
Phone(404) 664-6398
Fax(678) 705-2758
Sole ProprietorYes
Enumeration DateJanuary 25, 2016
✔ NPI 1912364787 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
License✔ Licensed in GA · 1823
550 PHARR RD NE, Atlanta, GA 30305
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Other Providers at the Same Location NPPES 8

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

PEACHTREE ORAL & MAXILLOFACIAL SURGERY ASSOCIATES
Dentist (Oral and Maxillofacial Surgery)
550 PHARR RD NE, SUITE 325
ATLANTA, GA 30305
Fulton County (404) 233-8221
DR. MICHAEL MCHANEY DEMO DDS
Dentist (Oral and Maxillofacial Surgery)
550 PHARR RD NE, SUITE 325
ATLANTA, GA 30305
Fulton County (404) 233-8221
VALERIE S. MARLER PH.D.,P.C.
Psychologist (Clinical)
550 PHARR RD NE, SUITE 205
ATLANTA, GA 30305
Fulton County (404) 237-3492
NNENNA OKOR AKARONU MD
Psychiatry & Neurology (Psychiatry)
550 PHARR RD NE
ATLANTA, GA 30305
Fulton County (404) 235-5982
VALERIE S MARLER,PH.D.,P.C.
Psychologist (Clinical)
550 PHARR RD NE, SUITE 205
ATLANTA, GA 30305
Fulton County (404) 237-3492
MONIQUE PAMPHILE L.AC
Acupuncturist
550 PHARR RD NE, SUITE 410
ATLANTA, GA 30305
Fulton County (770) 568-4216
DR. GREGORY PAUL MARKS D.D.S.
Dentist (Oral and Maxillofacial Surgery)
550 PHARR RD NE, SUITE 325
ATLANTA, GA 30305
Fulton County (404) 233-8221
ACUWELLNESS ATLANTA INC.
Acupuncturist
550 PHARR RD NE, SUITE 410
ATLANTA, GA 30305
Fulton County (404) 841-9994

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 Bonita Wallace's NPI number?

The NPI number for Bonita Wallace is 1912364787. It was assigned to this individual provider in the NPPES registry on January 25, 2016.

Where is Bonita Wallace located?

Bonita Wallace practices at 550 Pharr Rd NE Suite 605, Atlanta, GA 30305. The listed phone number is (404) 664-6398.

What is Bonita Wallace's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

When was this NPI record last updated?

The NPPES record for Bonita Wallace was last updated on January 25, 2016. NPI Profile syncs with the weekly NPPES data releases published by CMS.