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

Christopher Scott Wallace, LCSW

Individual provider Clinical Social Worker · NPI 1366974610

Christopher Scott Wallace, LCSW is a Clinical Social Worker in Phoenix, Arizona. Practices as a sole proprietor. Licensed in Arizona, Maryland and Virginia.

Licensed in
AZ, MD, VA
In the registry since
2017
Specialties on file
3
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

101 N 1st Ave Ste 2325
Phoenix, AZ 85003-1933
Phone: (480) 569-1604
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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 22821 (AZ)
Clinical Social Worker Taxonomy 1041C0700X · Licence 17443 (MD)
Clinical Social Worker Taxonomy 1041C0700X · Licence 0904009872 (VA)

Record details

NPI number1366974610
Entity typeIndividual (Type 1)
GenderMale
Credentials LCSW
Sole proprietorYes
NPI enumeratedMarch 28, 2017
Last updated in NPPESApril 5, 2025
Certification dateApril 5, 2025

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