Individual provider · Type 1 NPI

Nichole Wallace

Clinical Social Worker · Grand Rapids, MI

NPI number 1407546229 Active

Practice location

678 Front Ave NW Ste 100
Grand Rapids, MI 49504-5323

Call (616) 916-3711 Map

Mailing address

101 Fuller Ave SE
Grand Rapids, MI 49506-1635

Specialties and licenses

TaxonomyCodeLicense
Clinical Social Worker Primary 1041C0700X6851116253 (MI)

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 1407546229

Nichole Wallace's National Provider Identifier is 1407546229, issued on May 15, 2023. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in Grand Rapids, MI. The record was last updated on May 15, 2023.