Formecia Wallace, MA, MS
- Affiliated sites
- 1
- State license
- 1
- Year NPI issued
- 2019
- Practice address
- 4901 Glenwood Ave Suite 300, Raleigh, NC 27612
- Practice phone
- Call (912) 401-8303
- Professional email
- Get professional email
- Personal email
- Get personal email
- Mobile number
- Get mobile number
Primary practice
Mako Medical - Raleigh
Mobile Lab · Raleigh, North Carolina
Find Formecia Wallace's professional email, personal email and mobile number
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Formecia Wallace is an addiction (substance use disorder) counselor in Raleigh, North Carolina
Formecia Wallace practices at Mako Medical - Raleigh in Raleigh, North Carolina.
Formecia Wallace's NPI, 1518423045, was assigned on February 20, 2019. Formecia Wallace holds North Carolina license 25169.
- NPI
- 1518423045NPI Registry (opens in a new tab)
- NPI enumeration date
- February 20, 2019
- NPI status
- Active
- Practice phone
- (912) 401-8303
- Professional email
- Get email
- Personal email
- Get email
- Mobile number
- Get number
- Sex
- Female
Sources: NPPES NPI Registry (CMS); Dmand AI Professional Profile Data; and Dmand AI Affiliation Data
Formecia Wallace practices at Mako Medical - Raleigh in Raleigh, North Carolina
Formecia Wallace's primary practice is Mako Medical - Raleigh, at 4901 Glenwood Ave Suite 300, Raleigh, NC 27612. The practice phone is (912) 401-8303.
- Mako Medical - Raleigh4901 Glenwood Ave Suite 300, Raleigh, NC 27612Phone(912) 401-8303
Source: Dmand AI Affiliation Data
Formecia Wallace is affiliated with 1 site of care
Formecia Wallace's primary practice is Mako Medical - Raleigh in Raleigh, North Carolina.
Sources: Dmand AI Affiliation Data; and Dmand AI Org Hierarchy Data
Dmand AI tracks the EHR system at Formecia Wallace's practice
Dmand AI tracks the electronic health record (EHR) system at each site where Formecia Wallace practices. Vendor and product names are available with a free account.
| Site | EHR vendor and product |
|---|---|
| Mako Medical - Raleigh | Available with a free account |
Source: Dmand AI Technology Install Data
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Formecia Wallace is one of 405 addiction (substance use disorder) counselors in North Carolina
Counselor is Formecia Wallace's primary specialty in the NPI Registry, under taxonomy code 101YA0400X. The record also lists addiction (substance use disorder). Formecia Wallace is licensed in North Carolina.
Specialties and state licenses
- Addiction (substance use disorder) counselor, North CarolinaPrimary
Addiction (substance use disorder) counselors near Formecia Wallace
Counts of addiction (substance use disorder) counselors with a Dmand AI profile, by place and practice. Each opens the list.
Sources: NPPES NPI Registry (CMS); Dmand AI Professional Profile Data; and Dmand AI Peer Benchmarks
Formecia Wallace's patients have a median age of 48
Across all payers, Dmand AI patient panel data puts Formecia Wallace's median patient age at 48, with 29% women.
Formecia Wallace's patients across all payers
Dmand AI patient panel data covers Medicare, Medicaid and commercial patients.
Patient panel by age, all payers
Median age 48
Patient panel by sex, all payers
- Women29%
- Men71%
Source: Dmand AI Patient Panel Data
Sources for Formecia Wallace's profile data
| Data on this page | Source |
|---|---|
| NPI, name, sex, specialty and licenses | NPPES NPI Registry (CMS) (opens in a new tab)Dmand AI Professional Profile Data |
| Practice locations and phone | Dmand AI Affiliation Data |
| Primary practice, affiliations and health system | Dmand AI Affiliation DataDmand AI Org Hierarchy Data |
| Medicare patients and the all-payer patient panel | Dmand AI Patient Panel Data |
| EHR at each practice site | Dmand AI Technology Install Data |
| Similar physicians | Dmand AI Affiliation Data |
Data last refreshed October 2026Report an inaccuracyRemove my information
FAQ
Frequently asked questions about Formecia Wallace
Spotted something out of date? Email hello@dmand.ai and we will check the record. Contact details live in the free trial.
What is Formecia Wallace's NPI number?
Formecia Wallace's NPI number is 1518423045. It was assigned on February 20, 2019, and it is active in the NPI Registry.
What does Formecia Wallace specialize in?
Formecia Wallace is an addiction (substance use disorder) counselor in Raleigh, North Carolina. The primary specialty in the NPI Registry is Addiction (Substance Use Disorder) Counselor (taxonomy code 101YA0400X).
Where does Formecia Wallace practice?
Formecia Wallace practices at 4901 Glenwood Ave Suite 300, Raleigh, NC 27612. Formecia Wallace's primary practice is Mako Medical - Raleigh in Raleigh, North Carolina.
What is Formecia Wallace's office phone number?
The practice phone on file for Formecia Wallace is (912) 401-8303.
What is Formecia Wallace's medical license number?
Formecia Wallace holds North Carolina license 25169.
How long has Formecia Wallace been practicing?
Formecia Wallace's NPI was assigned in 2019.
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