Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
KATHI WALLACE, L.C.P.C.
Active Sole ProprietorKATHI WALLACE, L.C.P.C. is a Professional Counselor healthcare provider located in MARYVILLE, Illinois. NPI 1114319092 is currently active in the NPPES registry. Verify at CMS.
Professional Counselor · MARYVILLE, IL
Registration Details
- NPI Number
- 1114319092
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Mar 2, 2015 (11.430135467532 yrs)
- Last Updated
- Feb 2, 2022
- Licenses
-
2013036985 (MO)IL#180.009256 (IL)180.009256 (IL)
- Sole Proprietor
- Yes
Practice Information
- Address
-
5 SCHIBER CT STE DMARYVILLE, IL, 620625606Browse IL providers · Browse ZIP 62062
- Phone
- 3146264285
- Primary Specialty
-
Professional Counselor
101YP2500X
- Additional Specialty
- Professional Counselor
- Additional Specialty
- Professional Counselor
Other Professional Counselor Providers in MARYVILLE, IL
| Name | Credential | NPI |
|---|---|---|
| MR. REGINALD WYNN HOLT | MA, LCPC, LPC, CADC | 1487602827 |
| KIM HASTY | M.S., LCPC | 1780693515 |
| MRS. ANN LK MILLIKIN | LCPC | 1629188792 |
| MS. TAMERA J BOWLES | LCPC ATR BC | 1952451668 |
| MR. MARCUS A. PIPER | M.S., L.C.P.C. | 1144364316 |
| JEAN MCGURK O'BRIEN | M.A., LCPC, NCC | 1093993925 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.