Carolyn Ann Wallace, LCADC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

260417 Issued in KY

Practice address

2600 W Broadway
Louisville, KY 40211-1366

Phone

(502) 690-4286

NPI assigned

Feb 27, 2020

Last updated

Sep 29, 2026By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Connecting Services & Recovery LLC

  • Multi-Specialty Clinic/Center
  • Louisville, KY
  • NPI 1386478295

  Addiction (Substance Use Disorder)

  NPD
• Can-Teens Foundation

  • Adolescent and Children Mental Health Clinic/Center
  • Louisville, KY
  • NPI 1801568092
  NPD (past)

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

{
    "created_epoch": "1582761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790640000000",
    "number": "1306470455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "323 N 42ND ST",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402122747",
            "telephone_number": "502-356-8210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 W BROADWAY",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402111366",
            "telephone_number": "502-690-4286"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "323 N 42nd St",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "402122747",
            "country_code": "US",
            "telephone_number": "502-356-8210",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "CAROLYN",
        "middle_name": "ANN",
        "credential": "LCADC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-02-27",
        "last_updated": "2026-09-29",
        "certification_date": "2020-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "KY",
            "license": "260417",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julia Elizabeth Wall, MS, OTR/L
• Wallace Therapy Inc
• Deborah Wallace-Graham, MA, BCBA, LBA
• Allen Keith Wallace Jr.
• Bennett Allan Wallace, M.S.S.W
• Courtney Creal Wallace, LCSW, CADC
• Deborah I Wallace, M.D.
• Elizabeth Keller Wallace, MA, CFY-SLP
• Kali Wallace, APRN
• Kiara Learlene Wallace, MD

• Addiction (Substance Use Disorder) Counselor in Louisville, KY
• Providers in Louisville, KY by specialty
• Addiction (Substance Use Disorder) Counselor in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2026; 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.