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Nicholas Wallace, LPC, NCC, CCMHC
NPI 1356747430 · on the registry since 2014 · sole proprietor
Practice
- Address
- 90 Kingston Xing Apt 1506
Bossier City, LA 71111 - Phone
- (318) 935-0105
- Clinicians at this address
- 2
Registry record
- Primary taxonomy
- Professional Counselor
101YP2500X
- Also registered as
- Mental Health Counselor
- Licence states on file
- LA
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2021-06-06
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Louisiana