Individual provider · Type 1 NPI

Nicole Broadway Wallace, LPCC

Professional Counselor · Killeen, TX

NPI number 1821311606 Active

Practice location

207 Belo Dr
Killeen, TX 76542-5598

Call (254) 630-7450 Map

Fax (254) 853-4241

Mailing address

2201 S. Ws Young Dr, Suite 106-C Office 105
Killeen, TX 76543

Specialties and licenses

TaxonomyCodeLicense
Professional Counselor 101YP2500X19501 (TX)
Professional Counselor Primary 101YP2500X9626 (CA)

Professional Counselor: Definition to come...

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About NPI 1821311606

Nicole Broadway Wallace, LPCC's National Provider Identifier is 1821311606, issued on Mar 8, 2010. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Killeen, TX. The record was last updated on Jun 23, 2025.