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

Annisha Wallace, LCSW

Individual provider Social Worker · NPI 1346962768

Annisha Wallace, LCSW is a Social Worker in Phoenix, Arizona. Works from 2 locations. Licensed in Arizona.

Licensed in
AZ
In the registry since
2022
Specialties on file
2
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

610 E Baseline Rd Ste 5
Phoenix, AZ 85042-6536
Phone: (602) 230-7373
Fax: (602) 441-5836
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 2204 S Dobson Rd Ste 201, Mesa, AZ 85202-6457 — (602) 230-7373

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence LCSW-21745 (AZ)
Social Worker Taxonomy 104100000X · Licence LMSW-18807 (AZ)

Record details

NPI number1346962768
Entity typeIndividual (Type 1)
GenderFemale
Credentials LCSW
Sole proprietorNo
NPI enumeratedSeptember 13, 2022
Last updated in NPPESNovember 30, 2023
Certification dateNovember 30, 2023
Mailing address3101 N Central Ave Ste 550, Phoenix, AZ 85012-2635

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