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Raychelle Sheryl Wallace
Mental Health Counselor in Brandon, Florida
NPI 1609464098

Raychelle Sheryl Wallace is a Mental Health Counselor based in Riverview, FL and is specialized in Mental Health. Raychelle Sheryl Wallace practices in Brandon, FL. The NPI Number for Raychelle Sheryl Wallace is 1609464098 and holds a License No. IMH18337 (Florida).

The current practice location address for Raychelle Sheryl Wallace is 673 W Lumsden Rd, Brandon, FL and can be reached out via phone at 813-798-0800 and via fax at 813-798-7800. You can also correspond with Raychelle Sheryl Wallace through the mailing address at 11705 BOYETTE RD, RIVERVIEW, FL - 33569 (mailing address contact number: 813-798-0800).

Location: 673 W Lumsden Rd, Brandon, FL, 33569
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1609464098
Provider Name
Raychelle Sheryl Wallace
Credential
Provider Entity Type
Individual
Gender
Female
Address
673 W Lumsden Rd, Brandon, FL, 33569
Phone Number
813-798-0800
Fax Number
813-798-7800
Provider Enumeration Date
01/02/2021
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
673 W Lumsden Rd
City
Brandon
State
Florida
Zip
33511-5911
Phone Number
813-798-0800
Fax Number
813-798-7800
person
Provider Business Mailing Address Details
Address
11705 Boyette Rd
City
Riverview
State
Florida
Zip
33569
Phone Number
813-798-0800
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
101YM0800X
License No.
MH19813 (Florida)
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Agencies
Classification
Case Management
Speciality
-
Taxonomy
251B00000X
License No.
IMH18337 (Florida)
Definition
An organization that is responsible for providing case management services. The agency provides services which assist an individual in gaining access to needed medical, social, educational, and/or other services. Case management services may be used to locate, coordinate, and monitor necessary appropriate services. It may be used to encourage the use of cost-effective medical care by referrals to appropriate providers and to discourage over utilization of costly services. Case management may also serve to provide necessary coordination of non-medical services such as vocational rehabilitation, education, employment, when the services provided enable the individual to function at the highest level.
person
Provider's Taxonomy Details 3
Type
Agencies
Classification
Community/Behavioral Health
Speciality
-
Taxonomy
251S00000X
License No.
IMH18337 (Florida)
Definition
A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment.
person
Provider's Taxonomy Details 4
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Mental Health (Including Community Mental Health Center)
Taxonomy
261QM0801X
License No.
IMH18337 (Florida)
Definition
Definition to come...
person
Provider's Taxonomy Details 5
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Adult Mental Health
Taxonomy
261QM0850X
License No.
IMH18337 (Florida)
Definition
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults.
person
Provider's Taxonomy Details 6
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Adolescent and Children Mental Health
Taxonomy
261QM0855X
License No.
IMH18337 (Florida)
Definition
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in children and adolescents. Services may be provided to parents and family members of the patient in the form of conjoint, group, or individual therapy, and education and/or training.
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