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Organization
LOU ANN WALLIS, LPC, PC
Active
Organization
LOU ANN WALLIS, LPC, PC
Active
Other names
LIFECORDS
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LOUANN C WALLIS M.ED., LPC (PRESIDENT)
(830) 822-5054
Entity
Organization
Contact information
Practice address
468 S SEGUIN AVE, STE. 401, NEW BRAUNFELS, TX 78130-7664
(830) 822-5054
(830) 629-9700
Mailing address
468 S SEGUIN AVE, STE. 401, NEW BRAUNFELS, TX 78130-7664
(830) 822-5054
(830) 629-9700
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
15933
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1167146
INSURANCE PROVIDER ID
TX
01
—
12471
INSURANCE PROVIDER ID
TX
01
—
1508894783
INDIV. NPI
TX
01
—
232854
INSURANCE PROVIDER ID
TX
01
—
239642
INSURANCE PROVIDER ID
TX
01
—
506801
INSURANCE PROVIDER ID
TX
01
—
5096LC
BLUE CROSS BLUE SHIELD
TX
Enumeration date
03/07/2007
Last updated
08/22/2020
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