Tavia Wallace, MSW, LGSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

BP00947323 Issued in WV

Practice address

2121 7TH St
Parkersburg, WV 26101-3803

Phone

(304) 485-1721

NPI assigned

May 17, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Tavia Elder Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1463443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760659200000",
    "number": "1306293659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2121 7TH ST",
            "city": "PARKERSBURG",
            "state": "WV",
            "postal_code": "261013803",
            "telephone_number": "304-485-1721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2121 7TH ST",
            "city": "PARKERSBURG",
            "state": "WV",
            "postal_code": "261013803",
            "telephone_number": "304-485-1721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "TAVIA",
        "credential": "MSW, LGSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-17",
        "last_updated": "2025-10-17",
        "certification_date": "2025-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "WV",
            "license": "BP00947323",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1386795516",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TAVIA",
            "last_name": "ELDER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Marsha D Walker
• Reva Marie Walker
• Sara Ann Walker, LPN
• Skyla L Walker
• Jeffrey Paul Walkup
• Beth Wallbrown
• Camron Rea Walters
• Demara S Walters
• Erik Walters
• Jessika Ann Walters, CARE COORDINATOR

• Social Worker in Parkersburg, WV
• Providers in Parkersburg, WV by specialty
• Social Worker in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 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.

Verify at the official NPI Registry.