Anah Wallace, LCSW-A

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

P018641 Issued in NC

Practice address

9723 Northeast Pkwy Ste 500
Matthews, NC 28105-9718

Phone

(980) 349-6663

NPI assigned

Mar 15, 2023

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Family First Community Services LLC

  • Community/Behavioral Health Agency
  • Charlotte, NC
  • NPI 1891091641
  NPD (past)
• Family First Community Services, LLC

  • Community/Behavioral Health Agency
  • Charlotte, NC
  • NPI 1780871293

  Clinical

  NPD (past)

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

{
    "created_epoch": "1678838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678838400000",
    "number": "1639870702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2812 CROSS POINT CIR APT 37",
            "city": "MATTHEWS",
            "state": "NC",
            "postal_code": "281054425",
            "telephone_number": "980-349-6663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9723 NORTHEAST PKWY STE 500",
            "city": "MATTHEWS",
            "state": "NC",
            "postal_code": "281059718",
            "telephone_number": "980-349-6663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "ANAH",
        "credential": "LCSW-A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-15",
        "last_updated": "2023-03-15",
        "certification_date": "2023-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P018641",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Walgren Counseling, PLLC
• Christabelle McLean Walker, MSW, LCSWA
• Jerald Walker, CSFA
• Ellis B Wall
• Raygan Wall
• Kathy Wright Wallace, LPT
• Laura Walton
• Ashley Rene Wandera, RD
• Ward Foot Centers
• Eric Vaughn Ward, D.P.M.

• Clinical Social Worker in Matthews, NC
• Providers in Matthews, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2023; 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.