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

Jennifer Dawn Wallace, LPCC/S

Individual provider Professional Counselor · NPI 1174158976

Jennifer Dawn Wallace, LPCC/S is a Professional Counselor in Georgetown, Kentucky. Works from 2 locations. Licensed in Kentucky.

Licensed in
KY
In the registry since
2020
Specialties on file
2
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Practice location Address checks out

204 Bevins Ln Ste A
Georgetown, KY 40324-6145
Phone: (859) 951-9777
Fax: (859) 951-9779
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 200 Bevins Ln Ste E, Georgetown, KY 40324-8532 — (859) 951-9777

Specialties & licences

Professional Counselor (primary) Taxonomy 101YP2500X · Licence 104157
Counselor Taxonomy 101Y00000X · Licence 104157 (KY)

Record details

NPI number1174158976
Entity typeIndividual (Type 1)
GenderFemale
Credentials LPCC/S
Sole proprietorNo
NPI enumeratedMarch 12, 2020
Last updated in NPPESNovember 20, 2020
Certification dateNovember 20, 2020

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