Kanishia Wallace, - Counselor in Deerfield Beach, FL

Kanishia Wallace, is a Counselor - Mental Health based in Deerfield Beach, Florida. Kanishia Wallace is licensed to practice in * (Not Available) (license number ) and her current practice location is 500 Fairway Dr Ste 102, Deerfield Beach, Florida. She can be reached at her office (for appointments etc.) via phone at (888) 880-9270.

NPI number for Kanishia Wallace is 1023413515 and her current mailing address is 500 Fairway Dr Ste 102, Deerfield Beach, Florida. She does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1023413515.

Contact Information

Kanishia Wallace,
500 Fairway Dr Ste 102,
Deerfield Beach, FL 33441-1817
(888) 880-9270
Not Available

Map and Direction


Healthcare Provider's Profile

Full NameKanishia Wallace
GenderFemale
SpecialityCounselor - Mental Health
Location500 Fairway Dr Ste 102, Deerfield Beach, Florida
Accepts Medicare AssignmentsDoes not participate in Medicare Program. She may not accept medicare assignment.
  NPI Data:
  • NPI Number: 1023413515
  • Provider Enumeration Date: 10/27/2014
  • Last Update Date: 05/03/2019

Medical Identifiers

Medical identifiers for Kanishia Wallace such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1023413515NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
101YM0800XCounselor - Mental Health (* (Not Available))Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Kanishia Wallace is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Kanishia Wallace,
500 Fairway Dr Ste 102,
Deerfield Beach, FL 33441-1817

Ph: (888) 880-9270
Kanishia Wallace,
500 Fairway Dr Ste 102,
Deerfield Beach, FL 33441-1817

Ph: (888) 880-9270

Reviews and Comments


Counselor in Deerfield Beach, FL

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