Active NPI
Tara Wallace
- Clinical Social Worker
- Topeka, KS
National Provider Identifier
1043633027
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 4741
- Practice address
- 225 SW 12TH St RM 205
Topeka, KS 66612-1310 - Phone
- (785) 633-9453
- Fax
- (785) 727-4006
- NPI assigned
- Jan 28, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 9072 | KS | |
| Clinical Social Worker | 1041C0700X | 4741 | KS | Primary |
Addresses
Primary practice location
225 SW 12TH St RM 205
Topeka, KS 66612-1310
Mailing address
325 SW Frazier Ave
Topeka, KS 66606-1963
Phone (785) 232-5005
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9072 | KS | MD | Social Worker |
| 4741 | KS | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1390867200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1750982400000",
"number": "1043633027",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "325 SW FRAZIER AVE",
"city": "TOPEKA",
"state": "KS",
"postal_code": "666061963",
"telephone_number": "785-232-5005"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "225 SW 12TH ST RM 205",
"city": "TOPEKA",
"state": "KS",
"postal_code": "666121310",
"telephone_number": "785-633-9453",
"fax_number": "785-727-4006"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALLACE",
"first_name": "TARA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-01-28",
"last_updated": "2025-06-27",
"certification_date": "2025-06-27",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "KS",
"license": "9072",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "KS",
"license": "4741",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Topeka, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.