Jermaine Wallace
Mental Health Counselor
223 E Main St Suite 300
Rock Hill
, South Carolina 29730-4571
Jermaine Wallace
Mental Health Counselor
223 E Main St Suite 300
Rock Hill
, South Carolina 29730-4571
(803) 328-7141
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About
Features
Specialties
- Mental Health Counselor
Languages spoken
- English
Location
First Address
- Jermaine Wallace
- 250 Piedmont Blvd
- Rock Hill, SC
- Zip : 29732-1835
- Fax : (803) 328-7141
- Phone : (803) 328-9600
Second Address
- Jermaine Wallace
- 223 E Main St Suite 300
- Rock Hill, SC
- Zip : 29730-4571
- Fax : (803) 328-7141
- Phone : (803) 328-9600
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 101YM0800X | Mental Health Counselor |
National Provider Identifier
| NPI | 1003124025 |
|---|---|
| Provider Name | Jermaine Wallace |
| First Address | Rock Hill, SC 29732-1835 |
| Second Address | Rock Hill, SC 29730-4571 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 24/09/2010 |
| Last Update Date | 24/09/2010 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.