Individual provider Active NPI

Stephanie Hord-Wallace, LCSW-C

  • Clinical Social Worker
  • Columbia, MD
National Provider Identifier
1740075423
Registry record updated Apr 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
13687 Issued in MD
Practice address
6005 Camelback LN
Columbia, MD 21045-3810
Phone
(240) 331-8178
NPI assigned
Apr 12, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 12, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 13687 MD Primary

Addresses

Primary practice location

6005 Camelback LN
Columbia, MD 21045-3810

Mailing address

6005 Camelback LN
Columbia, MD 21045-3810

Other names 1

  • Stephanie Wallace Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
13687MDMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1744416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744416000000",
    "number": "1740075423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6005 CAMELBACK LN",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210453810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6005 CAMELBACK LN",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210453810",
            "telephone_number": "240-331-8178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HORD-WALLACE",
        "first_name": "STEPHANIE",
        "credential": "LCSW-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-04-12",
        "last_updated": "2025-04-12",
        "certification_date": "2025-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "13687",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEPHANIE",
            "last_name": "WALLACE",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Columbia, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2025; 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.