Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1871044255 Individual Practitioner Female Practitioner

Ebonie Wallace

Case Manager/Care Coordinator • Daytona Beach, FL

Professional Overview & Biography Verified Profile Summary

Ebonie Wallace is a registered healthcare professional specializing in Case Manager/Care Coordinator in Daytona Beach, FL. Practice services are available at 140 S BEACH ST STE 310 under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

140 S Beach St Ste 310

Daytona Beach, FL 321144409

Telephone 3868986040
Fax 3862562320
Associated Practice Facility / Clinic
🏢 Embridge Counseling Services Facility NPI 1750771622

Specialty Benchmarks & Practice Insights

Comparative analytics for Case Manager/Care Coordinator in Daytona Beach, FL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 14.4 Yrs
Regional Practice Density
117 Specialists

Practicing in Daytona Beach, FL (5060 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2021-02-18
Case Manager/Care Coordinator Primary Specialty

NUCC Taxonomy Code: 171M00000X

A person who provides case management services and assists an individual in gaining access to needed medical, social, educational, and/or other services. The person has the ability to provide an assessment and review of completed plan of care on a periodic basis. This person is also able to take collaborative action to coordinate the services with other providers and monitor the enrollee's progress toward the cost-effective achievement of objectives specified in the plan of care. Credentials may vary from an experience in the fields of psychology, social work, rehabilitation, nursing or a closely related human service field, to a related Assoc of Arts Degree or to nursing credentials. Some states may require certification in case management.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
019212700 (FL)

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

36 Associated Practitioners
Skylar Theiss

Behavior Technician

NPI 1003708355
Robin Warrington

Early Intervention Provider Agency

NPI 1013664713
Aspen Neace , COTA, L

Occupational Therapy Assistant

NPI 1023614898

Certified Occupational Therapy Assistant, L

Hailey Rhodes

Specialist/Technologist - Speech-Language Assistant

NPI 1033082045
Stephanie Cebula

Behavior Technician

NPI 1063097335
Christina Bass

Behavior Technician

NPI 1063130326

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

8 Historical Events
📍
Updated Practice Location February 18, 2021

Registered at 140 S BEACH ST STE 310, DAYTONA BEACH, FL 321144409 (Tel: 3868986040)

📍
Updated Business Mailing Address February 18, 2021

Registered at 140 S BEACH ST, DAYTONA BEACH, FL 321144472 (Tel: 3868986040)

NPI Profile Active October 20, 2016

NPI status registered as active in NPPES database

📍
Updated Practice Location October 20, 2016

Registered at 6239 YELLOWSTONE DR, PORT ORANGE, FL 321276756 (Tel: 3868724892)

📍
Updated Business Mailing Address October 20, 2016

Registered at 6239 YELLOWSTONE DR, PORT ORANGE, FL 321276756 (Tel: 3868724892)

👤
Provider Name / Credentials Updated October 20, 2016

Recorded as EBONIE WALLACE

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) October 20, 2016

Case Manager/Care Coordinator

🟢
Initial NPI Registration & Enumeration October 20, 2016

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1871044255
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: October 20, 2016
Last Update: February 18, 2021
Sole Proprietor: No

Mailing Address

140 S Beach St

Daytona Beach, FL 321144472

Phone: 3868986040

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.