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

Tyshaundra Renee Wallace, MED, LCASA, QP

Individual provider Mental Health Counselor · NPI 1669937595

Tyshaundra Renee Wallace, MED, LCASA, QP is a Mental Health Counselor in High Point, North Carolina. Licensed in North Carolina. Registered with an NPI since 2019.

Licensed in
NC
In the registry since
2019
What do these letters mean?
MED — Master of Education
A graduate education degree, written M.Ed.

See every abbreviation used in this directory →

Practice location Address checks out

1001 Phillips Ave
High Point, NC 27262-7251
Phone: (336) 854-2560
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Mental Health Counselor (primary) Taxonomy 101YM0800X · Licence LCAS-25036 (NC)

Record details

NPI number1669937595
Entity typeIndividual (Type 1)
GenderFemale
Credentials MED , LCASA , QP
Sole proprietorNo
NPI enumeratedFebruary 5, 2019
Last updated in NPPESJune 9, 2026
Certification dateJune 9, 2026

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