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Dedra Wallace

NPI 1063810877ActiveIndividual· Counselor, Professional· Pueblo, CO

Counselor, Professional with Health Solutions, practicing in Pueblo, Colorado. Enrolled in Medicare as practitioner - mental health counselor.

Overview

NPI1063810877
StatusActive
Entity typeIndividual
Sole proprietorNo
NPI issuedDec 10, 2014
Last updated in NPPESOct 19, 2016

Specialties and licenses

TaxonomyCodeLicenseState
Counselor, Professional Primary101YP2500XLPC.0013214CO

About license numbers in NPPES

Exclusion screening

ListResultDetails
HHS-OIG LEIE · Nov 10, 2026No matchChecked by NPI and by name + state
North Carolina Medicaid · Nov 11, 2026No match—
New York OMIG · Nov 11, 2026No match—
Ohio Medicaid · Nov 11, 2026No match—
Pennsylvania Medicheck · Nov 11, 2026No match—
Washington HCA · Nov 11, 2026No match—

Official OIG search · How matching works ·Bulk check a roster

Medicare

Enrollment (PECOS)Enrolled Practitioner - Mental Health Counselor (CO)

Medicare sources and data years

Education and affiliations

Graduation year2014
Medicare specialtyMental Health Counselor

Medical group

Source: CMS Care Compare

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