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

Donielle R Wallace

Individual provider Social Worker · NPI 1073135521

Donielle R Wallace is a Clinical Social Worker in Cincinnati, Ohio. Qualified in 2020, 6 years ago. Practices with Psychological and Behavioral Consultants LLC, a 577-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Ohio.

Years since qualifying
6
Licensed in
OH
In the registry since
2020
Specialties on file
2
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Practice location Address checks out

2135 Dana Ave Ste 220
Cincinnati, OH 45207-1342
Phone: (216) 468-5000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 207d Colegate Dr, Marietta, OH 45750-2363 — (740) 376-0930

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence I.2405894 (OH)
Social Worker Taxonomy 104100000X · Licence S.1904386 (OH)

Record details

NPI number1073135521
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedMay 7, 2020
Last updated in NPPESMarch 10, 2025
Certification dateMarch 10, 2025
Mailing address207d Colegate Dr, Marietta, OH 45750-2363

Medicare enrollment

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

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Psychological And Behavioral Consultants Llc — 577 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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