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

Kathi Wallace, LCPC

Individual provider Professional Counselor · NPI 1114319092

Kathi Wallace, LCPC is a Professional Counselor in Maryville, Illinois. Practices as a sole proprietor and works from 2 locations. Licensed in Illinois and Missouri.

Licensed in
IL, MO
In the registry since
2015
Specialties on file
3
What do these letters mean?
LCPC — Licensed Clinical Professional Counselor
A licensed clinical counsellor.

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Practice location Address checks out

5 Schiber Ct Ste D
Maryville, IL 62062-5606
Phone: (314) 626-4285
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 301 Sovereign Ct Ste 211, Ballwin, MO 63011-4435 — (314) 626-4285

Specialties & licences

Professional Counselor (primary) Taxonomy 101YP2500X · Licence 180.009256 (IL)
Professional Counselor Taxonomy 101YP2500X · Licence 2013036985 (MO)
Professional Counselor Taxonomy 101YP2500X · Licence IL#180.009256 (IL)

Record details

NPI number1114319092
Entity typeIndividual (Type 1)
GenderFemale
Credentials LCPC
Sole proprietorYes
NPI enumeratedMarch 2, 2015
Last updated in NPPESFebruary 2, 2022
Certification dateFebruary 2, 2022
Mailing address27 Windermere Dr, Glen Carbon, IL 62034-1477

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