Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Jill N Wallace LCSW PLLC

Organization Social Worker · NPI 1356760037

Jill N Wallace LCSW PLLC is a Social Worker in East Northport, New York. Licensed in New York. Registered with an NPI since 2014.

Licensed in
NY
In the registry since
2014
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

15 Heath Ln
East Northport, NY 11731-1912
Phone: (516) 459-0312
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Social Worker (primary) Taxonomy 104100000X · Licence R045832 (NY)

Record details

NPI number1356760037
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jill Wallace — Owner · (516) 459-0312
NPI enumeratedApril 10, 2014
Last updated in NPPESJuly 19, 2024
Certification dateJuly 19, 2024
Mailing address15 Heath Ln, East Northport, NY 11731-1912

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