Katrina Lanet Wallace, LGSW

Primary specialty

School Social WorkerTaxonomy code 1041S0200X

License

LG50083646 Issued in DC

Practice address

2146 24TH PL NE # 2
Washington, DC 20018-1402

Phone

(202) 774-5442

NPI assigned

May 25, 2023

Last updated

May 25, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

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

{
    "created_epoch": "1684972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684972800000",
    "number": "1942992938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14913 DENNINGTON DR",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207213273",
            "telephone_number": "301-351-0984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2146 24TH PL NE # 2",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200181402",
            "telephone_number": "202-774-5442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "KATRINA",
        "middle_name": "LANET",
        "name_prefix": "Mrs.",
        "credential": "LGSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-05-25",
        "last_updated": "2023-05-25",
        "certification_date": "2023-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041S0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, School",
            "state": "DC",
            "license": "LG50083646",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jala Wallace
• Jessica Wallace
• Jessica Faye Wallace, PA-C
• Jordan Malik Wallace
• Juna Wallace
• Kristen Elizabeth Wallace, PMHNP
• Ladonna Wallace
• Latorie Wallace
• Laura A Wallace
• Linda Wallace

• School Social Worker in Washington, DC
• Providers in Washington, DC by specialty
• School Social Worker in District of Columbia

• 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.