Individual provider · Type 1 NPI
Raychelle Sheryl Wallace
Mental Health Counselor · Brandon, FL
NPI number
1609464098
Active
Practice location
673 W Lumsden Rd
Brandon, FL 33511-5911
Fax (813) 798-7800
Mailing address
11705 Boyette Rd, Pmb 430
Riverview, FL 33569
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Community/Behavioral Health Agency | 251S00000X | IMH18337 (FL) |
| Mental Health Clinic/Center (Including Community Mental Health Center) | 261QM0801X | IMH18337 (FL) |
| Case Management Agency | 251B00000X | IMH18337 (FL) |
| Adult Mental Health Clinic/Center | 261QM0850X | IMH18337 (FL) |
| Adolescent and Children Mental Health Clinic/Center | 261QM0855X | IMH18337 (FL) |
| Mental Health Counselor Primary | 101YM0800X | MH19813 (FL) |
Mental Health Counselor: Definition to come...
2 other providers at this address
Other mental health counselor providers in Brandon
- Mary Escudie, LMHCMental Health Counselor Brandon, FL NPI 1003155003
- Niambi Espada, LMHCMental Health Counselor Brandon, FL NPI 1003558008
- Matthew Rauch, LMHCMental Health Counselor Brandon, FL NPI 1013430834
- Kaitlyn KennyMental Health Counselor Brandon, FL NPI 1013843879
- Jeannine Jones, LMHCMental Health Counselor Brandon, FL NPI 1023383221
- Starr Hall, MAMental Health Counselor Brandon, FL NPI 1023481215
- Angie Murray, LMHCMental Health Counselor Brandon, FL NPI 1033397112
- Cloie N. Williams, LMHCMental Health Counselor Brandon, FL NPI 1043360472
About NPI 1609464098
Raychelle Sheryl Wallace's National Provider Identifier is 1609464098, issued on Jan 2, 2021. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Brandon, FL. The record was last updated on Aug 14, 2023.