Dedra Wallace
Professional Counselor · Pueblo, CO
Dedra Wallace is a professional counselor with a practice address in Pueblo, Colorado, and NPI 1063810877, issued on Dec 10, 2014. Check the license (Colorado LPC.0013214, as entered in NPPES) with the Colorado board that licenses this profession; the Medicare figures below come from public CMS files.
- Name
- Dedra Wallace
- Primary taxonomy
- Professional Counselor 101YP2500X
- License number
- LPC.0013214 CO
Self-reported in NPPES; status is on the state search - Practice location
- 1302 Chinook LN, Pueblo, CO 81001
- Phone
- (719) 545-2746
- Enumerated
- Dec 10, 2014
- Record last updated
- Oct 19, 2016 (not updated in 10 years: call before relying on the address or phone)
- Fax
- (719) 545-4100
- Medicare enrollment
- Enrolled (PECOS I20240104004874); accepts Medicare assignment
- Entity
- Type 1 · individual
8 nearest professional counselor records → All 6,935 in Colorado → Look up another NPI →
Also registered at 1302 Chinook LN
A shared address usually means a shared clinic or building; it does not show who employs whom.
- Samantha AhlersCounselor1518353101
- Stephanie AkerRegistered Nurse1972134633
- Albert AlexanderMental Health Counselor1235504390
- Charlotte AlleeCounselor1912242967
- Larissa AndersonRegistered Nurse1922501881
- Jennifer AndrewsRegistered Nurse1245848969
Verify Dedra Wallace in five checks
- 1IdentityNPI record in CMS NPPESNPI lookupConfirmed in NPPES
- 2LicenseActive license and public ordersWhich Colorado board licenses this profession
Search for license LPC.0013214Check the board - 3Other statesLicenses and actions elsewhereDocInfo (FSMB)Not checked
- 4ExclusionsMedicare and Medicaid bansHHS-OIG exclusion listNot checked
- 5CertificationBoard certificationABMS AOA NCCPA AANPNot checked
Bills Medicare through one group practice
- Health SolutionsPueblo, CO
Source: CMS Doctors and Clinicians National Downloadable File (the group practices a clinician bills Medicare through) (data.cms.gov).
Dedra Wallace among 6,935 professional counselor records in Colorado
Dedra Wallace is one of 6,935 professional counselor records with a practice address in Colorado. 12% of them appear in a Medicare file (Part D prescribing, MIPS, Open Payments or Medicare group billing); this one does. Its NPI, issued in 2014, is newer than 36% of them.
- NPI issued2014 · 36% of these records are older, 59% newer
- In a Medicare fileYes · 12% of these records are
- In the CMS Doctors and Clinicians fileYes · 19% of these records are
- Graduated2014 · median 2016 among the 1,339 with a school on file
- Record last updated2016 · 45% of these records were not updated in five years or more
Source: CMS NPPES, file of Aug 9, 2026, every record with primary taxonomy 101YP2500X and a Colorado practice address; Medicare files: CMS Part D Prescribers 2024, MIPS 2023, Open Payments 2024, Doctors and Clinicians (data.cms.gov).
163 professional counselor records list a practice address in Pueblo
They are 163 of the 3,717 NPPES records with a practice address in Pueblo, and 6,935 professional counselor records in Colorado.
All 6,935 in Colorado → Every provider in Pueblo → Professional Counselor nationwide →
The 8 professional counselor records with the nearest ZIP codes
- Ray Gradisar, LPCPueblo, CO 810011881737559
- Martha Griego, NCC, LPCPueblo, CO 810011194858878
- Stacy Hladek, LPCPueblo, CO 810011841323516
- Ricco Nancy Julia, LCPCPueblo, CO 810011043360795
- Tammy Laborde, LPCPueblo, CO 810011710010491
- Rene Larrabee, LPCPueblo, CO 810011568504611
- Victoria Linden, LPCPueblo, CO 810011689716631
- Mary Martin, LPCPueblo, CO 810011962544015
Common questions
What is Dedra Wallace's NPI number?
Dedra Wallace's National Provider Identifier (NPI) is 1063810877, issued on Dec 10, 2014. An NPI identifies a provider in billing; it is not a license.
Where is Dedra Wallace located?
The NPPES record lists a practice address at 1302 Chinook LN, Pueblo, CO, 81001. Phone: (719) 545-2746. Providers update this record themselves, so call before visiting.
How can I verify Dedra Wallace's license?
NPPES lists Colorado license number LPC.0013214, as entered by the provider. Search the Colorado board that licenses this profession; the NPPES record confirms identity only.
Source: CMS National Plan and Provider Enumeration System (NPPES), file of Aug 9, 2026 (NPPES files on CMS.gov); NUCC Health Care Provider Taxonomy. Medicare files from data.cms.gov. An NPI identifies who bills; it is not a license.
Figures on PlainDoctor are read from the federal files each page names (CMS NPPES, Medicare Part D, MIPS, Open Payments; the HHS-OIG exclusion list only as counts) and from Census population estimates, with the file date shown beside them. See our editorial standards & corrections policy, the methodology behind these numbers, or report a data error. Data current as of Aug 9, 2026.