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

Misty Lee Wallace

Individual provider Mental Health Counselor · NPI 1104790625

Misty Lee Wallace is a Mental Health Counselor in Las Vegas, Nevada. Registered with an NPI since 2025.

In the registry since
2025

Practice location Address checks out

7040 Laredo St Ste D
Las Vegas, NV 89117-3044
Phone: (775) 237-8629
Show map & directions

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

Specialties & licences

Mental Health Counselor (primary) Taxonomy 101YM0800X

Record details

NPI number1104790625
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedSeptember 30, 2025
Last updated in NPPESSeptember 30, 2025
Certification dateSeptember 29, 2025

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