DEBORAH WALLIS (LAC) – Mental Health Counselor, NPI 1790908374

DEBORAH WALLIS (LAC) is a healthcare provider. based in Nashville, Arkansas. specializing in MENTAL HEALTH COUNSELOR. They hold the professional credentials LAC. They hold a License No. A0302010 (AR). The NPI Number for DEBORAH WALLIS (LAC) is 1790908374

Main info

Female
26 Years Of Experience
Accepts Medicare Assignment
Name
DEBORAH WALLIS (LAC)
NPI
1790908374
Phone
(870) 451-9742
Address
1575 HIGHWAY 371 W
Enumeration Date
11 April 2007
Last Update Date
8 July 2007

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8704550134
Graduation Year
2000 (26 years ago)
PAC ID
9830542570
Group Practice PAC ID
0547665382
Professional Enrollment ID
I20240129003533
Address ID
AR718523925NA508XXSTXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

640 MENTAL HEALTH COUNSELOR in AR

Provider Addresses for DEBORAH WALLIS (LAC)

  • 1575 HIGHWAY 371 W

    NASHVILLE, AR 718527598

    Phone: (870) 451-9742

    Fax: (870) 451-9752

    Type: Location

  • 127 WOODRUFF LN

    NASHVILLE, AR 718527542

    Phone: (870) 557-1094

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-01-29

PECOS data refreshed: 2026-06-15

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20240129003533IMental Health CounselorARTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 71852)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 0547665382View full group profile
NameSpecialtyState
Mental Health CounselorAR
Mental Health CounselorAR
Mental Health CounselorAR
Mental Health CounselorAR
Family PracticeAR
Mental Health CounselorAR
Mental Health CounselorAR
Mental Health CounselorAR
Mental Health CounselorAR
Nurse PractitionerAR

Reviews

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Frequently asked questions

Can I cross-check DEBORAH WALLIS (LAC) using NPI 1790908374?
NPI 1790908374 belongs to DEBORAH WALLIS (LAC); compare other details if you need extra assurance.
Would DEBORAH WALLIS (LAC) appear as active to a payer?
You can treat DEBORAH WALLIS (LAC) as active for directory purposes; confirm clinical privileges separately.
What clinical focus is listed for DEBORAH WALLIS (LAC)?
At a glance, DEBORAH WALLIS (LAC) is tied to Mental Health Counselor. Clinical services aligned with this taxonomy classification.
Is DEBORAH WALLIS (LAC) associated with Nashville?
Public fields place DEBORAH WALLIS (LAC) around Nashville, Arkansas. Always confirm the exact site before visiting.
When was this NPI issued?
Enumeration for DEBORAH WALLIS (LAC) is noted as April 11, 2007 where the registry provides it.

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