Individual provider · Type 1 NPI

Tamika Shavone Wallace, LCSW- A

Clinical Social Worker · Fayetteville, NC

NPI number 1629415070 Active

Practice location

511 Middle Rd
Fayetteville, NC 28312-5207

Call (910) 584-3564 Map

Specialties and licenses

TaxonomyCodeLicense
Clinical Social Worker Primary 1041C0700XP009482 (NC)

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 1629415070

Tamika Shavone Wallace, LCSW- A's National Provider Identifier is 1629415070, issued on May 24, 2013. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in Fayetteville, NC. The record was last updated on May 19, 2015.