Individual provider · Type 1 NPI

Michelle Wallace, LCSW

Clinical Social Worker · Bend, OR

NPI number 1336796374 Active

Practice location

1340 NW Wall St
Bend, OR 97703-1985

Call (541) 322-7500 Map

Fax (541) 322-7565

Mailing address

2577 NE Courtney Dr
Bend, OR 97701-7752

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor 101YM0800XNone listed
Clinical Social Worker Primary 1041C0700XL11322 (OR)

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 1336796374

Michelle Wallace, LCSW's National Provider Identifier is 1336796374, issued on Aug 23, 2019. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in Bend, OR. The record was last updated on Apr 17, 2023.