Marisa Wallace, LPC

Professional Counselor · Mentor, OH

Individual Active NPI

NPI number 1316417439

Practice location

7232 Justin Way
Mentor, OH 44060-4881
Phone
(440) 578-8200

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NPI record

NPI
1316417439
Entity type
Individual (Type 1)
Enumeration date
December 1, 2018
Last updated
February 17, 2022
Certified
February 17, 2022
Sole proprietor
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Professional Counselor Primary 101YP2500X C.190690 OH
Student in an Organized Health Care Education/Training Program 390200000X — —

Other practice locations (1)

  • 23780 Farringdon Ave, Euclid, OH 44123-1537 · (216) 240-1111

About Marisa Wallace

Marisa Wallace, LPC is a healthcare provider registered in the NPI registry with the primary taxonomy Professional Counselor (code 101YP2500X). The practice location is 7232 Justin Way, Mentor, OH 44060-4881. The NPI number 1316417439 was assigned on December 1, 2018 and the record was last updated on February 17, 2022.

Marisa Wallace lists a license in the registry: #C.190690 (OH) for Professional Counselor. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Marisa Wallace, LPC?

The NPI number is 1316417439.

What is the phone number of Marisa Wallace?

The phone number listed for the practice location is (440) 578-8200.

Where is Marisa Wallace located?

7232 Justin Way, Mentor, OH 44060-4881.

What is the taxonomy code for Marisa Wallace?

The primary taxonomy code is 101YP2500X – Professional Counselor; 1 more listed above.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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