Casey Ann Wallace
Social Worker, Clinical in Chicago, IL. Individual provider (NPI-1).
NPI number1346824331
StatusActive
Last updated in NPPESJul 4, 2024
Details
- NPI
- 1346824331
- Entity type
- Individual (NPI-1)
- Name
- Casey Ann Wallace
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- May 6, 2021
- Certification date
- Jul 4, 2024
- Last updated
- Jul 4, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1041C0700X | Social Worker, Clinical | 149026886 | IL | Yes |
| 104100000X | Social Worker | – | – |
Practice location
2845 N Sheridan RdSuite 809
Chicago, IL 60657
Phone 312-761-4721
Mailing address
3024 N Lincoln Ave Unit FChicago, IL 60657-4253
Phone 269-760-4020
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