Dana J. Wallace, LCSW, LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

DANA J. WALLACE, LCSW, LLC

Practice address

480 Santa Rosa Blvd Unit 308E
Fort Walton Beach, FL 32548-6945

Phone

(251) 421-0712

NPI assigned

May 14, 2026

Last updated

May 14, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dana Janelle Wallace, LCSW, LICSWNPI 1144747205

Title

Social Worker/Psychtherapist

Phone

(251) 421-0712

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Dana Wallace, LCSW, LICSW

  • Clinical Social Worker
  • Fort Walton Beach, FL
  • NPI 1144747205
  NPD Authorized official

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

{
    "created_epoch": "1778716800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1778716800000",
    "number": "1457280828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "480 SANTA ROSA BLVD UNIT 308E",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325486945",
            "telephone_number": "251-421-0712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "480 SANTA ROSA BLVD UNIT 308E",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325486945",
            "telephone_number": "251-421-0712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DANA J. WALLACE, LCSW, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-05-14",
        "last_updated": "2026-05-14",
        "certification_date": "2026-05-13",
        "status": "A",
        "authorized_official_last_name": "WALLACE",
        "authorized_official_first_name": "DANA",
        "authorized_official_middle_name": "JANELLE",
        "authorized_official_title_or_position": "SOCIAL WORKER/PSYCHTHERAPIST",
        "authorized_official_telephone_number": "251-421-0712",
        "authorized_official_credential": "LCSW, LICSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• CW Holistic Counseling LLC
• Ashley D'Amico, DNP, FNP-BC
• Jennifer Meshell Dahlberg
• Lisa Dailey
• John Christofer Dali, M.D.
• Daniel Bader M.D., PA
• Hien Dao, MD
• Erica Darby
• Andrea Davis-Aguirre
• Caroline Elizabeth Davis, APRN

• Clinical Social Worker in Fort Walton Beach, FL
• Providers in Fort Walton Beach, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 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.