Individual provider · Type 1 NPI

Dana Wallace, LCSW, LICSW

Clinical Social Worker · Fort Walton Beach, FL

NPI number 1144747205 Active

Practice location

480 Santa Rosa Blvd
Fort Walton Beach, FL 32548-6901

Call (251) 421-0712 Map

Mailing address

480 Santa Rosa Blvd Unit 308E
Fort Walton Beach, FL 32548-6945

Specialties and licenses

TaxonomyCodeLicense
Clinical Social Worker Primary 1041C0700XSW24920 (FL)
Clinical Social Worker 1041C0700X6143C (AL)

Clinical Social Worker: A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpers…

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About NPI 1144747205

Dana Wallace, LCSW, LICSW's National Provider Identifier is 1144747205, issued on Aug 29, 2017. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in Fort Walton Beach, FL. The record was last updated on May 6, 2026.