Individual provider · Type 1 NPI

Courtney Creal Wallace, LCSW, CADC

Clinical Social Worker · Louisville, KY

NPI number 1548692189 Active

Practice location

1432 S Shelby St
Louisville, KY 40217-1166

Call (502) 635-4538 Map

Fax (502) 635-4570

Mailing address

1436 S Shelby St
Louisville, KY 40217-1107

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor 101YA0400X1771 (KY)
Clinical Social Worker Primary 1041C0700X3882 (KY)

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 1548692189

Courtney Creal Wallace, LCSW, CADC's National Provider Identifier is 1548692189, issued on Aug 6, 2013. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in Louisville, KY. The record was last updated on May 28, 2014.