Brooke Wallace, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

5568-C Issued in AR

Practice address

1521 Merrill Drive
Suite D220
Little Rock, AR 72211-1654

Phone

(501) 660-6893

Fax

(501) 954-7798

NPI assigned

Mar 5, 2014

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 names 1

• Brooke Schulz Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1393977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718582400000",
    "number": "1649696394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 251970",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722251970",
            "telephone_number": "501-666-8686",
            "fax_number": "501-660-6830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1521 MERRILL DRIVE",
            "address_2": "SUITE D220",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722111654",
            "telephone_number": "501-660-6893",
            "fax_number": "501-954-7798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "BROOKE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-05",
        "last_updated": "2024-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AR",
            "license": "5568-C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BROOKE",
            "last_name": "SCHULZ",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Yvette Walker
• Brandon James Wall, MD
• Janet O Wall, RD
• Joseph Curlin Wall, P.T.
• Ashanti Wallace, QBHP
• Carmen Nicole Wallace
• Cassandra Wallace, LPTN
• Chakiah Wallace, LAC
• Chrisopher Wallace
• Jamelia Wallace

• Clinical Social Worker in Little Rock, AR
• Providers in Little Rock, AR by specialty
• Clinical Social Worker in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.