Individual provider · Type 1 NPI

Jastyn N. Wallace, MSW, LISW

Clinical Social Worker · Columbus, OH

NPI number 1710895867 Active

Practice location

1581 Dodd Dr
Columbus, OH 43210-1257

Call (614) 685-3192 Map

Fax (614) 366-4709

Mailing address

700 Ackerman Rd Ste 2120
Columbus, OH 43202-1559

Specialties and licenses

TaxonomyCodeLicense
Clinical Social Worker Primary 1041C0700XI.2608121 (OH)

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 1710895867

Jastyn N. Wallace, MSW, LISW's National Provider Identifier is 1710895867, issued on Aug 31, 2026. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in Columbus, OH. The record was last updated on Sep 18, 2026.