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

Loretta Wallace

Individual provider Addiction (Substance Use Disorder) Counselor · NPI 1932043957

Loretta Wallace is an Addiction (Substance Use Disorder) Counselor in New York, New York. Practices as a sole proprietor. Licensed in New York.

Licensed in
NY
In the registry since
2026

Practice location Address checks out

60 E 112th St Apt 402
New York, NY 10029-0314
Phone: (646) 245-7639
Show map & directions

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

Specialties & licences

Addiction (Substance Use Disorder) Counselor (primary) Taxonomy 101YA0400X · Licence 41880 (NY)

Record details

NPI number1932043957
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedApril 18, 2026
Last updated in NPPESApril 18, 2026
Certification dateApril 18, 2026

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