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

Individual provider Clinical Social Worker · NPI 1851572606

Camilla Wallace, LCSW is a Clinical Social Worker in Evanston, Illinois. Qualified in 2006, 20 years ago. Practices with Bmsc Az LLC, a 133-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Illinois and Michigan.

Years since qualifying
20
Licensed in
IL, MI
In the registry since
2007
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

1007 Church St Ste 302
Evanston, IL 60201-3624
Phone: (847) 492-1938
Fax: (847) 423-5670
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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 149.013306 (IL)
Clinical Social Worker Taxonomy 1041C0700X · Licence 6801093324 (MI)

Record details

NPI number1851572606
Entity typeIndividual (Type 1)
GenderFemale
Credentials LCSW
Sole proprietorNo
NPI enumeratedNovember 21, 2007
Last updated in NPPESSeptember 16, 2013

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2006 (20 years in practice)
Group practice Bmsc Az Llc — 133 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

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