Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. John R. Wallis, DMIN

Individual provider Pastoral Counselor · NPI 1023161197

Dr. John R. Wallis, DMIN is a Pastoral Counselor in Ft Lauderdale, Florida. Licensed in Florida. Registered with an NPI since 2007.

Licensed in
FL
In the registry since
2007

Practice location Address checks out

1417 SE 4th St
Ft Lauderdale, FL 33301-2319
Phone: (954) 463-2273
Fax: (954) 779-1643
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pastoral Counselor (primary) Taxonomy 101YP1600X · Licence MT1251 (FL)

Record details

NPI number1023161197
Entity typeIndividual (Type 1)
GenderMale
Credentials DMIN
Sole proprietorNo
NPI enumeratedJanuary 19, 2007
Last updated in NPPESJuly 8, 2007
Mailing address1417 Se 4th St, Ft Lauderdale, FL 33301-2319