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

Selina Samantha Wallace

Individual provider Professional Counselor · NPI 1558226621

Selina Samantha Wallace is a Mental Health Counselor in Hampton, Virginia. Qualified in 2016, 10 years ago. Licensed in Virginia.

Years since qualifying
10
Licensed in
VA
In the registry since
2025
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Practice location Address checks out

2244 Executive Dr
Hampton, VA 23666-2430
Phone: (757) 827-1001
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Professional Counselor (primary) Taxonomy 101YP2500X · Licence 0701015709 (VA)

Record details

NPI number1558226621
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedDecember 19, 2025
Last updated in NPPESDecember 19, 2025
Certification dateDecember 19, 2025
Mailing address261 Belmont Cir, Yorktown, VA 23693-4451

Medicare enrollment

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

Medicare specialtyMENTAL HEALTH COUNSELOR
Medical schoolOTHER
Graduated 2016 (10 years in practice)
Accepts Medicare assignment Not indicated

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