Jastyn Wallace, MSW, LISW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

I.2608121 Issued in OH

Practice address

1581 Dodd Dr
Columbus, OH 43210-1257

Phone

(614) 685-3192

Fax

(614) 366-4709

NPI assigned

Aug 31, 2026

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

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

{
    "created_epoch": "1788134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789689600000",
    "number": "1710895867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 ACKERMAN RD STE 2120",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432021559",
            "telephone_number": "614-685-6701",
            "fax_number": "614-366-4709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1581 DODD DR",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432101257",
            "telephone_number": "614-685-3192",
            "fax_number": "614-366-4709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "JASTYN",
        "middle_name": "N",
        "credential": "MSW, LISW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-08-31",
        "last_updated": "2026-09-18",
        "certification_date": "2026-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.2608121",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daiveah Wallace
• Deanna Marie Wallace
• Elizabeth Ann Wallace, DC
• Hailey D Wallace, CRNA
• Janet Ann Wallace, CNP
• Kelly Dugan Wallace
• Margot Wallace, RN, LSN
• Molly Wallace
• Nicolas Wallace
• Peter Yarkpazuo Wallace

• Clinical Social Worker in Columbus, OH
• Providers in Columbus, OH by specialty
• Clinical Social Worker in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.