DoctorDataHub
Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

KATI WALLACE

Active Sole Proprietor

KATI WALLACE is a Clinical Social Worker healthcare provider located in CLOVERDALE, Indiana. NPI 1245072073 is currently active in the NPPES registry. Verify at CMS.

Clinical Social Worker · CLOVERDALE, IN

Registration Details

NPI Number
1245072073
Provider Type
Individual
Gender
Female
NPI Issued
Jun 11, 2024 (2.158710187839 yrs)
Last Updated
Oct 3, 2025
License
34010387A (IN)
Sole Proprietor
Yes

Practice Information

Address
3 W BOONE ST
CLOVERDALE, IN, 461209003
Browse IN providers · Browse ZIP 46120
Phone
8126059748
Primary Specialty
Clinical Social Worker
1041C0700X
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.