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

Andrew Nathan Wallace, LCSW

Individual provider Clinical Social Worker · NPI 1295433167

Andrew Nathan Wallace, LCSW is a Clinical Social Worker in Canton, Georgia. Licensed in Georgia. Registered with an NPI since 2023.

Licensed in
GA
In the registry since
2023
What do these letters mean?
LCSW — Licensed Clinical Social Worker
A social worker licensed to diagnose and treat mental health conditions independently.

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Practice location Address checks out

191 Lamar Haley Pkwy
Canton, GA 30114-8019
Phone: (770) 704-1600
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence CSW008417 (GA)

Record details

NPI number1295433167
Entity typeIndividual (Type 1)
GenderMale
Credentials LCSW
Sole proprietorNo
NPI enumeratedFebruary 21, 2023
Last updated in NPPESApril 25, 2023
Certification dateApril 25, 2023
Mailing address1193 Wade Green Cir Nw, Acworth, GA 30102-3491

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