Individual provider · Type 1 NPI
Nicholas Preston Wallace, LPC, NCC, CCMHC
Professional Counselor · Bossier City, LA
NPI number
1356747430
Active
Practice location
90 Kingston Xing Apt 1506
Bossier City, LA 71111-6289
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Mental Health Counselor | 101YM0800X | LPC #5493 (LA) |
| Professional Counselor Primary | 101YP2500X | LPC #5493 (LA) |
Professional Counselor: Definition to come...
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About NPI 1356747430
Nicholas Preston Wallace, LPC, NCC, CCMHC's National Provider Identifier is 1356747430, issued on Nov 17, 2014. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Bossier City, LA. The record was last updated on Jun 6, 2021.