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

Leah Jo Wallace, LPC

Individual provider Professional Counselor · NPI 1235804121

Leah Jo Wallace, LPC is a Mental Health Counselor in Caruthersville, Missouri. Qualified in 2021, 5 years ago. Practices with Family Counseling Center Inc, a 39-clinician group, works from 2 locations and accepts Medicare assignment.

Years since qualifying
5
In the registry since
2021
What do these letters mean?
LPC — Licensed Professional Counselor
A licensed mental health counsellor.

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Practice location Address checks out

915 Highway 84 W
Caruthersville, MO 63830-8113
Phone: (573) 333-5975
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 935 State Route Vv, Kennett, MO 63857-3822 — (573) 888-5925

Specialties & licences

Professional Counselor (primary) Taxonomy 101YP2500X

Record details

NPI number1235804121
Entity typeIndividual (Type 1)
GenderFemale
Credentials LPC
Sole proprietorNo
NPI enumeratedAugust 12, 2021
Last updated in NPPESOctober 16, 2023
Certification dateOctober 16, 2023
Mailing address935 State Route Vv, Kennett, MO 63857-3822

Medicare enrollment

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

Medicare specialtyMENTAL HEALTH COUNSELOR
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Family Counseling Center Inc — 39 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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