Individual provider · Type 1 NPI
Amanda Wallace
Mental Health Counselor · Indianapolis, IN
NPI number
1770169955
Active
Practice location
8401 Harcourt Rd
Indianapolis, IN 46260-2073
Fax (317) 338-4890
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Mental Health Counselor | 101YM0800X | 88001290A (IN) |
| Mental Health Counselor | 101YM0800X | 10594 (SC) |
| Mental Health Counselor Primary | 101YM0800X | 39004417A (IN) |
Mental Health Counselor: Definition to come...
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About NPI 1770169955
Amanda Wallace's National Provider Identifier is 1770169955, issued on Mar 19, 2021. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Indianapolis, IN. The record was last updated on Apr 19, 2025.