Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Darryl John Wallace, CSC-AD

Individual provider Counselor · NPI 1639047343

Darryl John Wallace, CSC-AD is a Counselor in Baltimore, Maryland. Practices as a sole proprietor. Licensed in Maryland.

Licensed in
MD
In the registry since
2025
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Practice location Address checks out

5900 York Rd Ste 201
Baltimore, MD 21212-3097
Phone: (443) 563-1021
Fax: (443) 869-3749
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Counselor (primary) Taxonomy 101Y00000X · Licence SC3481 (MD)

Record details

NPI number1639047343
Entity typeIndividual (Type 1)
GenderMale
Credentials CSC-AD
Sole proprietorYes
NPI enumeratedOctober 24, 2025
Last updated in NPPESOctober 24, 2025
Certification dateOctober 24, 2025

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