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Deactivated NPI 1093042301 Deactivated / Inactive NPI Male Practitioner

Emmanuel Floyd Wall , CDP

Counselor • Vancouver, WA

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Emmanuel Wall has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date November 06, 2009
NPI Deactivation Date November 25, 2020
Total Practice Duration ~11 Years of Practice (2009 – 2020)

Professional Overview & Biography Verified Profile Summary

Emmanuel Wall, CDP was a registered Counselor practicing in Vancouver, WA. Throughout an active medical career spanning 11 years, Emmanuel Wall provided care at the practice location at 1601 E FOURTH PLAIN BLVD BLDG 17 until profile deactivation on 2020-11-25.

Practice Location & Contact Primary Location

Practice Address

1601 E Fourth Plain Blvd Bldg 17

Vancouver, WA 986613753

Telephone 3603978246
Fax 3603978230
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Counselor in Vancouver, WA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 13.9 Yrs
State Avg: 13.0 Yrs
Regional Practice Density
679 Specialists

Practicing in Vancouver, WA (11556 Statewide)

Telehealth Adoption Rate
0.3% 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 Primary Specialty

NUCC Taxonomy Code: 101Y00000X

State License WA CP00002167

A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.

Practice Associates & Co-Workers

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

40 Associated Practitioners
NPI 1003043332

Master of Social Work

Leticia Cuevas

Counselor - Addiction (Substance Use Disorder)

NPI 1003354259
Laura Tenney , SUDPT

Counselor - Addiction (Substance Use Disorder)

NPI 1003443482
Ena Valjevac

Counselor

NPI 1003458894
Jacob Hammond , CMHC

Counselor - Mental Health

NPI 1003654765
Marry-Kate Lindsey , SUDPT

Counselor - Addiction (Substance Use Disorder)

NPI 1003686171

Career & Practice History Timeline

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

7 Historical Events
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NPI Profile Deactivated November 25, 2020

Record deactivated on November 25, 2020

NPI Profile Active November 06, 2009

NPI status registered as active in NPPES database

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Updated Practice Location November 06, 2009

Registered at 1601 E FOURTH PLAIN BLVD BLDG 17, VANCOUVER, WA 986613753 (Tel: 3603978246)

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Updated Business Mailing Address November 06, 2009

Registered at 1601 E FOURTH PLAIN BLVD BLDG 17, VANCOUVER, WA 986613753 (Tel: 3603978246)

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Provider Name / Credentials Updated November 06, 2009

Recorded as EMMANUEL WALL, CDP

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Medical Taxonomy / Specialty Registered (Primary Specialty) November 06, 2009

Counselor (License #CP00002167 in WA)

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Initial NPI Registration & Enumeration November 06, 2009

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: 1093042301
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: November 06, 2009
Last Update: November 06, 2009
Deactivation Date: November 25, 2020

Mailing Address

1601 E Fourth Plain Blvd Bldg 17

Vancouver, WA 986613753

Phone: 3603978246

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.