Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1619271228 Individual Practitioner Female Practitioner

Debra J Wallace , PCC-S, LICDC

Counselor - Professional • Alliance, OH

Professional Overview & Biography Verified Profile Summary

Debra Wallace, PCC-S, LICDC is a registered healthcare professional specializing in Counselor - Professional in Alliance, OH. Practice services are available at 1207 W STATE ST under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

1207 W State St
Suite F

Alliance, OH 446014686

Telephone 3308213846
Fax 3308215172
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Counselor - Professional in Alliance, OH

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.8 Yrs
State Avg: 15.9 Yrs
Regional Practice Density
15 Specialists

Practicing in Alliance, OH (6923 Statewide)

Telehealth Adoption Rate
6.7% 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

Counselor - Professional Primary Specialty

NUCC Taxonomy Code: 101YP2500X

State License OH E.0900224-SUPV

Definition to come...

Counselor - Addiction (Substance Use Disorder)

NUCC Taxonomy Code: 101YA0400X

State License OH LICDC.151044-CS

Definition to come...

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
0182777 (OH)

Practice Associates & Co-Workers

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

13 Associated Practitioners
Christina Kumpus , RN

Registered Nurse - Community Health

NPI 1144535683

Registered Nurse

Dr. Mark Hostettler , MD

Internal Medicine

NPI 1265431753

Doctor of Medicine (M.D.)

Jennifer Rahde

Counselor - Mental Health

NPI 1275947046
NPI 1336604404
Sandra Mcclish , LPC

Counselor - Mental Health

NPI 1346360153

Licensed Professional Counselor

Leslie Tranovich , PCC, CDCA

Counselor - Professional

NPI 1427008127

PCC, Chemical Dependency Counselor Assistant

Career & Practice History Timeline

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

11 Historical Events
NPI Profile Active March 01, 2017

NPI status registered as active in NPPES database

📍
Updated Practice Location March 01, 2017

Registered at 1207 W STATE ST, SUITE F, ALLIANCE, OH 446014686 (Tel: 3308213846)

📍
Updated Business Mailing Address March 01, 2017

Registered at 625 CLEVELAND AVE NW, CANTON, OH 447021805 (Tel: 3304538252)

👤
Provider Name / Credentials Updated March 01, 2017

Recorded as DEBRA WALLACE, PCC-S, LICDC

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) March 01, 2017

Counselor (License #LICDC.151044-CS in OH)

NPI Profile Active December 23, 2010

NPI status registered as active in NPPES database

📍
Updated Practice Location December 23, 2010

Registered at 100 LINCOLN WAY E, SUITE 180, MASSILLON, OH 446466673 (Tel: 3308330234)

📍
Updated Business Mailing Address December 23, 2010

Registered at 1341 MARKET AVE N, CANTON, OH 447142605 (Tel: 3308330234)

👤
Provider Name / Credentials Updated December 23, 2010

Recorded as DEBRA WALLACE

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) December 23, 2010

Counselor (License #C0900224 in OH)

🟢
Initial NPI Registration & Enumeration December 23, 2010

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: 1619271228
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: December 23, 2010
Last Update: March 01, 2017
Sole Proprietor: No

Mailing Address

625 Cleveland Ave Nw

Canton, OH 447021805

Phone: 3304538252

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.