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

Carla R Wallace, LCSW

Individual provider Clinical Social Worker · NPI 1043892052

Carla R Wallace, LCSW is a Clinical Social Worker in Fayetteville, Arkansas. Practices as a sole proprietor. Licensed in Arkansas.

Licensed in
AR
In the registry since
2021
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

3465 N Northwood Ave
Fayetteville, AR 72704-5302
Phone: (285) 472-0882
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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 LCSW (AR)

Record details

NPI number1043892052
Entity typeIndividual (Type 1)
GenderFemale
Credentials LCSW
Sole proprietorYes
NPI enumeratedApril 28, 2021
Last updated in NPPESApril 28, 2021
Certification dateApril 28, 2021

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