Active NPI
Chakiah Wallace, LAC
- Counselor
- Little Rock, AR
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- A2411012
- Practice address
- 6501 W. 12TH, Street
Little Rock, AR 72204-1511 - Phone
- (501) 666-8686
- Fax
- (501) 660-6832
- NPI assigned
- Nov 5, 2024
- Last updated
- Sep 17, 2026
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | A2411012 | AR | Primary |
| Counselor | 101Y00000X | NU | ||
| Mental Health Counselor | 101YM0800X | A2411012 | AR | |
| Mental Health Counselor | 101YM0800X | NU |
Addresses
Primary practice location
6501 W. 12TH, Street
Little Rock, AR 72204-1511
Mailing address
P.O. Box 251970
Little Rock, AR 72225-1970
Phone (501) 666-8686
Other practice location 1
11215 Hermitage Rd Ste 204
Little Rock, AR 72211-3864
Phone (501) 777-5969
Other practice location 2
513 Main St
North Little Rock, AR 72114-5329
Phone (501) 777-5969
Other names 1
- Chakiah Elaine Wallace
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
| License | State | Type | Specialty |
|---|---|---|---|
| A2411012 | AR | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| McCoy Counseling LLC | Counselor | Current | Accepting new patients |
| Mental Wellness Connection | Mental Health | Current | Accepting new patients |
Locations
11215 Hermitage Rd
Ste 204
Little Rock, AR 72211
Phone (501) 283-7201
Organizations & group practices 2
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.
-
- Mental Health Counselor
- Bentonville, AR
- NPI 1740089929
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1730764800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1789603200000",
"number": "1902629199",
"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": "6501 W. 12TH, STREET",
"city": "LITTLE ROCK",
"state": "AR",
"postal_code": "722041511",
"telephone_number": "501-666-8686",
"fax_number": "501-660-6832"
}
],
"practiceLocations": [
{
"address_1": "11215 Hermitage Rd Ste 204",
"address_purpose": "LOCATION",
"city": "Little Rock",
"state": "AR",
"postal_code": "722113864",
"country_code": "US",
"telephone_number": "501-777-5969",
"fax_number": "501-379-9791",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "513 Main St",
"address_purpose": "LOCATION",
"city": "North Little Rock",
"state": "AR",
"postal_code": "721145329",
"country_code": "US",
"telephone_number": "501-777-5969",
"fax_number": "501-379-9791",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WALLACE",
"first_name": "CHAKIAH",
"credential": "LAC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-11-05",
"last_updated": "2026-09-17",
"certification_date": "2026-09-17",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "AR",
"license": "A2411012",
"primary": true
},
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "AR",
"license": "A2411012",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NU",
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "CHAKIAH",
"last_name": "WALLACE",
"middle_name": "ELAINE",
"credential": "LAC",
"code": "5",
"type": "Other Name"
}
]
}
Other providers in Little Rock, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.