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ALYSSA MARIE WALLACE LMHC
NPI 1992311047
Counselor - Mental Health in Syracuse, NY

Active since September 23, 2020PECOS Enrolled
1045 JAMES ST STE 100, SYRACUSE, NY 13203(315) 425-1004(315) 479-7884 Get Directions Write a Review

NPPES record last updated: May 1, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: May 1, 2023, Sep 23, 2020 (2 updates tracked since 2020).

About Alyssa Marie Wallace Lmhc NPPES

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

ALYSSA MARIE WALLACE LMHC (NPI 1992311047) is an individual mental health provider in Syracuse, New York, licensed in New York (01699) and active in the NPI registry since September 2020. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1992311047
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameALYSSA MARIE WALLACECredential: LMHC
Location Address1045 JAMES ST STE 100Syracuse, NY 13203-2758
Mailing Address1045 James St Ste 100Syracuse, NY 13203-2758 · (315) 425-1004 · Fax (315) 479-7884
Phone(315) 425-1004
Fax(315) 479-7884
Sole ProprietorNo
Enumeration DateSeptember 23, 2020
Last NPPES UpdateMay 1, 20232 updates tracked since enumeration
NPPES CertifiedMay 1, 2023
✔ NPI 1992311047 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
License✔ Licensed in NY · 01699
1045 JAMES ST STE 100, Syracuse, NY 13203
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Alyssa Marie Wallace Lmhc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer– Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

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. HEIDI M ZIERVOGEL LMSW
Social Worker
1045 JAMES ST STE 100
SYRACUSE, NY 13203
Onondaga County (315) 472-4471
MR. MARCIN ROBERT ZAK LMHC
Counselor (Mental Health)
1045 JAMES ST STE 100
SYRACUSE, NY 13203
Onondaga County (315) 472-4471
CAITLIN BECKER
Counselor (Mental Health)
1045 JAMES ST STE 100
SYRACUSE, NY 13203
Onondaga County (315) 472-4471
ADRIANA SOTOLONGO LMSW
Social Worker
1045 JAMES ST STE 100
SYRACUSE, NY 13203
Onondaga County (315) 425-1004
KAYLA CUNNINGHAM LMHC
Counselor
1045 JAMES ST STE 100
SYRACUSE, NY 13203
Onondaga County (315) 472-4471
MARTA MULHOLLAND PLMHC
Counselor (Mental Health)
1045 JAMES ST STE 100
SYRACUSE, NY 13203
Onondaga County (315) 472-4471
MAGGIE PRUSINOWSKI
Counselor (Mental Health)
1045 JAMES ST STE 100
SYRACUSE, NY 13203
Onondaga County (315) 424-1004
MISS LYNDSEY COURTNEY LADD FNP
Nurse Practitioner (Family)
1045 JAMES ST STE 100
SYRACUSE, NY 13203
Onondaga County (315) 472-4471

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 Alyssa Wallace's NPI number?

The NPI number for Alyssa Wallace is 1992311047. It was assigned to this individual provider in the NPPES registry on September 23, 2020.

Where is Alyssa Wallace located?

Alyssa Wallace practices at 1045 James St Ste 100, Syracuse, NY 13203. The listed phone number is (315) 425-1004.

What is Alyssa Wallace's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Is Alyssa Wallace enrolled in Medicare?

Yes. Alyssa Wallace is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Alyssa Wallace was last updated on May 1, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.