IndividualActive
Jacob Wallace
NPI 1639031503 · Mental Health Counselor · Palmetto Bay, FL
Jacob Wallace is a Mental Health Counselor provider in Palmetto Bay, FL (NPI 1639031503).
Provider details
- NPI number
- 1639031503
- Entity type
- Individual
- Primary specialty
- Mental Health CounselorBehavioral Health & Social Service Providers
- Sex
- Male
- Sole proprietor
- No
Specialties & taxonomies
Behavioral Health & Social Service Providers
Profile Score
Basic profile(47/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
Under 1 yr in registry
- Profile completeness38% of score
83% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
15924 Sw 92nd Ave
Palmetto Bay, FL 33157-1842
Phone: (305) 964-5824
Street-level locationGet directions
Mailing address
15175 Sw 111th St
Miami, FL 33196-2503
Registry dates
- Enumerated
- 2025-12-01
- Last updated
- 2025-12-01
- Certified
- 2025-12-01
Frequently asked questions
- What is Jacob Wallace's NPI number?
- Jacob Wallace's National Provider Identifier (NPI) is 1639031503, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Jacob Wallace's specialty?
- Jacob Wallace is listed in the NPPES registry with a primary specialty of Mental Health Counselor (Behavioral Health & Social Service Providers).
- Where is Jacob Wallace located?
- Jacob Wallace's practice location on file with NPPES is 15924 Sw 92nd Ave, Palmetto Bay, FL 33157-1842.
- What is Jacob Wallace's phone number?
- The practice phone number listed in the NPPES registry for Jacob Wallace is (305) 964-5824.
- Is Jacob Wallace's NPI active?
- Yes — Jacob Wallace's NPI (1639031503) is active in the NPPES registry as of the last update on 2025-12-01.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.