Individual provider · Type 1 NPI

Samala Wallack, LPC

Professional Counselor · St. Louis, MO

NPI number 1073995866 Active

Practice location

111 W Port Plz
St. Louis, MO 63146-3011

Call (816) 404-5700 Map

Mailing address

1800 Community
Clinton, MO 64735-8804

Specialties and licenses

TaxonomyCodeLicense
Professional Counselor Primary 101YP2500X2015008989 (MO)
Professional Counselor 101YP2500XMH27069 (FL)

Professional Counselor: Definition to come...

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About NPI 1073995866

Samala Wallack, LPC's National Provider Identifier is 1073995866, issued on Jun 29, 2015. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in St. Louis, MO. The record was last updated on Jun 23, 2026.