Individual provider · Type 1 NPI

Chulete Aurielle Wallace-Keane, LCSW

Clinical Social Worker · Moody Afb, GA

NPI number 1962894485 Active

Practice location

3280 Mitchell Blvd
Moody Afb, GA 31699-1500

Call (229) 257-2778 Map

Specialties and licenses

TaxonomyCodeLicense
Clinical Social Worker 1041C0700XNone listed
Clinical Social Worker Primary 1041C0700XC010976 (NC)

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 1962894485

Chulete Aurielle Wallace-Keane, LCSW's National Provider Identifier is 1962894485, issued on Feb 20, 2015. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in Moody Afb, GA. The record was last updated on Dec 4, 2023.