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

Mr. Coleman W Wallace

Individual provider Pastoral Counselor · NPI 1720863913

Mr. Coleman W Wallace is a Pastoral Counselor in Willingboro, New Jersey. Licensed in New Jersey. Registered with an NPI since 2023.

Licensed in
NJ
In the registry since
2023

Practice location Address checks out

15 Edge Ct
Willingboro, NJ 08046-2412
Phone: (609) 500-7139
Show map & directions

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

Specialties & licences

Pastoral Counselor (primary) Taxonomy 101YP1600X (NJ)

Record details

NPI number1720863913
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedAugust 28, 2023
Last updated in NPPESAugust 30, 2023
Certification dateAugust 30, 2023
Mailing address15 Edge Ct, Willingboro, NJ 08046-2412