Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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John Burton Wallace V, LCSW

Individual provider Social Worker · NPI 1437590973

John Burton Wallace V, LCSW is a Social Worker in Decatur, Georgia. Practices as a sole proprietor. Registered with an NPI since 2013.

In the registry since
2013
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

1123 Clairmont Rd
Decatur, GA 30030-1207
Phone: (917) 392-6700
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Social Worker (primary) Taxonomy 104100000X

Record details

NPI number1437590973
Entity typeIndividual (Type 1)
GenderMale
Credentials LCSW
Sole proprietorYes
NPI enumeratedJuly 12, 2013
Last updated in NPPESMarch 18, 2024
Certification dateAugust 10, 2023

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