Nathaniel Ross Wallo, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

15271 Issued in LA

Practice address

5610 Read Blvd
New Orleans, LA 70127-3106

Phone

(504) 241-8188

NPI assigned

Jul 4, 2019

Last updated

May 25, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• TGC Learning Center

  • Non-emergency Medical Transport (VAN)
  • Chalmette, LA
  • NPI 1982909511
  NPD (past)
• The Guidance Center Inc

  • Community/Behavioral Health Agency
  • Chalmette, LA
  • NPI 1992855977
  NPD (past)

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

{
    "created_epoch": "1562198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684972800000",
    "number": "1689236119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 CENTRAL AVE",
            "city": "JEFFERSON",
            "state": "LA",
            "postal_code": "701213401",
            "telephone_number": "504-214-7870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5610 READ BLVD",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701273106",
            "telephone_number": "504-241-8188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLO",
        "first_name": "NATHANIEL",
        "middle_name": "ROSS",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-07-04",
        "last_updated": "2023-05-25",
        "certification_date": "2023-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "LA",
            "license": "15271",
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brandy S Wallace
• Jetavia Wallace
• Leslie Austin Wallace, MSW, LCSW
• Brittany Jill Wallen, PHARM.D.
• John Brent Wallis, MD
• Phyllis B Wallo, MD
• Allison Grace Walls, MD
• Elisa Istre Walls, FNP-C
• Tityana Marie Walls
• Allison Ramos Walsh

• Clinical Social Worker in New Orleans, LA
• Providers in New Orleans, LA by specialty
• Clinical Social Worker in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 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.