Individual provider · Type 1 NPI
Amanda Kay Fackler Wallace, LPC
Professional Counselor · Richland, MI
NPI number
1023724127
Active
Practice location
8480 N 32nd St Unit 92
Richland, MI 49083-9817
Mailing address
5228 Lovers Ln Ste 102
Portage, MI 49002-1521
Other practice locations
- 115 N 2nd St, Roscommon, MI 48653-9209 · (810) 837-2046
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Professional Counselor Primary | 101YP2500X | 6401224616 (MI) |
| Mental Health Counselor | 101YM0800X | 6451022560 (MI) |
Professional Counselor: Definition to come...
Other professional counselor providers in Richland
About NPI 1023724127
Amanda Kay Fackler Wallace, LPC's National Provider Identifier is 1023724127, issued on Jan 24, 2023. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Richland, MI. The record was last updated on Feb 25, 2026.