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

Madison Wallace

Individual provider Community Health Worker · NPI 1972953172

Madison Wallace is a Qualified Speech Language Pathologist in Powell, Ohio. Qualified in 2022, 4 years ago. Practices as a sole proprietor. Licensed in Ohio.

Years since qualifying
4
Licensed in
OH
In the registry since
2016
Specialties on file
2

Practice location Address checks out

6977 Scioto Chase Blvd
Powell, OH 43065-7976
Phone: (715) 347-2419
Show map & directions

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

Specialties & licences

Speech-Language Pathologist (primary) Taxonomy 235Z00000X · Licence SP.16583 (OH)
Community Health Worker Taxonomy 172V00000X

Record details

NPI number1972953172
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedJune 18, 2016
Last updated in NPPESAugust 1, 2025
Certification dateAugust 1, 2025
Mailing address6977 Scioto Chase Blvd, Powell, OH 43065-7976

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyQUALIFIED SPEECH LANGUAGE PATHOLOGIST
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare