Individual provider · Type 1 NPI
Chakiah Wallace, LAC
Counselor · Little Rock, AR
NPI number
1902629199
Active
Practice location
6501 W. 12th, Street
Little Rock, AR 72204-1511
Fax (501) 660-6832
Mailing address
P.o. Box 251970
Little Rock, AR 72225-1970
Other practice locations
- 513 Main St, North Little Rock, AR 72114-5329 · (501) 777-5969
- 11215 Hermitage Rd Ste 204, Little Rock, AR 72211-3864 · (501) 777-5969
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Counselor Primary | 101Y00000X | A2411012 (AR) |
| Mental Health Counselor | 101YM0800X | A2411012 (AR) |
| Counselor | 101Y00000X | None listed |
| Mental Health Counselor | 101YM0800X | None listed |
Counselor: A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.
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About NPI 1902629199
Chakiah Wallace, LAC's National Provider Identifier is 1902629199, issued on Nov 5, 2024. The primary taxonomy on file is Counselor (101Y00000X), and the practice location is in Little Rock, AR. The record was last updated on Sep 17, 2026.