KATHLEEN MICHELLE WALLACE LPC NCC NPI 1508185307

NPI Information

  • NPI: 1508185307
  • Provider Name: KATHLEEN MICHELLE WALLACE, LPC, NCC
  • Classification: Counselor - 101YM0800X
  • Specialization: Mental Health
  • Entity Type: Individual
  • Address: 110 SKYLINE DR
    RUSSELLVILLE, AR
    ZIP 72801
  • Phone: (479) 968-1298

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NPI Details

Kathleen Michelle Wallace, LPC, NCC is a mental health counselor in Russellville, AR. Kathleen Michelle Wallace, LPC, NCC NPI is 1508185307. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

110 SKYLINE DR
RUSSELLVILLE, AR
ZIP 72801-362
Phone: (479) 968-1298
Fax: (479) 890-5364

The enumeration date for this NPI number is 5/19/2010 and was last updated on 2/15/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1101YM0800XCounselorMental HealthP1507083ARKANSASYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

NPI Synchronization or Removal

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