Allison Wallace, MSW, MFT

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

I.1600716 Issued in OH

Practice address

2456 Hearthstead LN
Cincinnati, OH 45239-6616

Phone

(404) 798-1055

NPI assigned

Mar 8, 2017

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1488931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488931200000",
    "number": "1023558103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2456 HEARTHSTEAD LN",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452396616",
            "telephone_number": "404-798-1055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2456 HEARTHSTEAD LN",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452396616",
            "telephone_number": "404-798-1055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "ALLISON",
        "credential": "MSW, MFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-03-08",
        "last_updated": "2017-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.1600716",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW005555",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shelby Wall
• Wallace Family Dentistry LLC
• Wallace Physician Services LLC
• Alex Wallace, MA, LMHC, LPCC
• Alexandria Wallace
• Anne M. Wallace, PH.D.
• Brandon Tobias Wallace, DMD
• Chasei Wallace
• Chiquita Wallace
• Christina Wallace

• Clinical Social Worker in Cincinnati, OH
• Providers in Cincinnati, OH by specialty
• Clinical Social Worker in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.