Individual provider · Type 1 NPI

Lisa Wallace, LCSW, LCDC

Clinical Social Worker · Georgetown, TX

NPI number 1760958458 Active

Practice location

2903 Gabriel View Dr
Georgetown, TX 78628-2707

Fax (512) 863-6833

Specialties and licenses

Taxonomy	Code	License
Clinical Social Worker Primary	1041C0700X	58545 (TX)
Addiction (Substance Use Disorder) Counselor	101YA0400X	12442 (TX)

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 1760958458

Lisa Wallace, LCSW, LCDC's National Provider Identifier is 1760958458, issued on Oct 19, 2018. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in Georgetown, TX. The record was last updated on Oct 28, 2021.