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Active NPI 1023399052 Individual Practitioner Male Practitioner

Stephen James Wallace , LPCC

Counselor - Professional • Canton, OH

Professional Overview & Biography Verified Profile Summary

Stephen Wallace, LPCC is a certified Counselor - Professional practicing in Canton, OH. With approximately 15 years of clinical experience since completing medical education in 2011, Stephen Wallace delivers high-quality medical care to the local community at 625 CLEVELAND AVE NW.

Stephen Wallace does not directly accept Medicare assignment.

Practice Location & Contact Primary Location

Practice Address

625 Cleveland Ave Nw

Canton, OH 447021805

Telephone 3304538252
Fax 3304536716
Associated Practice Facility / Clinic
🏢 Commquest Services, Inc. Facility NPI 1730168311

Medicare Profile & Education

Medical School

Other

Graduation Year

2011

Medicare Assignment

Not Specified

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Counselor - Professional in Canton, OH

Established Specialist (10-20 Yrs)
Practitioner Clinical Experience
15 Yrs +1.1 yrs vs City Avg
City Avg: 13.9 Yrs
State Avg: 15.9 Yrs
Regional Practice Density
316 Specialists

Practicing in Canton, OH (6923 Statewide)

Telehealth Adoption Rate
2.8% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Wallace (15 Years) 15 Yrs
Canton Specialty Average (13.9 Years) 13.9 Yrs

Medical Specialties & State Licenses

Counselor - Professional Primary Specialty

NUCC Taxonomy Code: 101YP2500X

State License OH E.1000187

Definition to come...

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
0168101 (OH)

Practice Associates & Co-Workers

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

40 Associated Practitioners
Joseph Lockett , LICDC

Counselor - Addiction (Substance Use Disorder)

NPI 1003085424
Amy Nelson , CT, CDCA

Counselor - Addiction (Substance Use Disorder)

NPI 1003272220

CT, Chemical Dependency Counselor Assistant

Hillary Whiteman

Counselor - Addiction (Substance Use Disorder)

NPI 1003365933
Morgan Truax

Community Health Worker

NPI 1003407149
NPI 1003577057
Jessica Austin , LPN

Licensed Practical Nurse

NPI 1023477130

Licensed Practical Nurse

Career & Practice History Timeline

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

11 Historical Events
NPI Profile Active March 02, 2017

NPI status registered as active in NPPES database

📍
Updated Practice Location March 02, 2017

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

📍
Updated Business Mailing Address March 02, 2017

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

👤
Provider Name / Credentials Updated March 02, 2017

Recorded as STEPHEN WALLACE, LPCC

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) March 02, 2017

Counselor (License #E.1000187 in OH)

NPI Profile Active September 03, 2011

NPI status registered as active in NPPES database

📍
Updated Practice Location September 03, 2011

Registered at 1341 MARKET AVE N, CANTON, OH 447142605 (Tel: 3304538252)

📍
Updated Business Mailing Address September 03, 2011

Registered at 1341 MARKET AVE N, CANTON, OH 447142605

👤
Provider Name / Credentials Updated September 03, 2011

Recorded as STEPHEN WALLACE, P.C.

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) September 03, 2011

Counselor (License #C. 1000187 in OH)

🟢
Initial NPI Registration & Enumeration September 03, 2011

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: 1023399052
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: September 03, 2011
Last Update: March 02, 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.