Barbara Mary Wallace, LCSWA

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

P013279 Issued in NC

Practice address

4921 Albemarle Rd Ste 108
Charlotte, NC 28205-6654

Phone

(980) 819-6585

Fax

(980) 833-1426

NPI assigned

Mar 25, 2019

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.

• Atra Counseling Services, PLLC

  • Community/Behavioral Health Agency
  • Charlotte, NC
  • NPI 1326533217
  NPD (past)
• Professional Resources Enhancing Personal Success LLP

  • Early Intervention Provider Agency
  • Charlotte, NC
  • NPI 1629538350
  NPD (past)

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

{
    "created_epoch": "1553472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553472000000",
    "number": "1649730656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6320 PINTO PL APT 8",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282137361",
            "telephone_number": "917-295-3430",
            "fax_number": "980-833-1426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4921 ALBEMARLE RD STE 108",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282056654",
            "telephone_number": "980-819-6585",
            "fax_number": "980-833-1426"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "BARBARA",
        "middle_name": "MARY",
        "name_prefix": "Ms.",
        "credential": "LCSWA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-25",
        "last_updated": "2019-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P013279",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Debbie Ann Wallace-Pratt, LCSWA
• Alysen Janae Wallace, MS, LPCA
• Andrea Nicole Wallace, FNP
• Anna Odessa Wallace
• Anya Wallace, PA-C
• Caleb Wallace, DPT
• Chloe Wallace
• Courtni Wallace
• Cynthia C Wallace, MA, LCMHCS, NCC
• Dawn Spruill Wallace, DDS

• Clinical Social Worker in Charlotte, NC
• Providers in Charlotte, 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 25, 2019; 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.