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

Michael David Wallace, LCSW

Individual provider Clinical Social Worker · NPI 1477610285

Michael David Wallace, LCSW is a Clinical Social Worker in Milwaukee, Wisconsin. Licensed in Wisconsin. Registered with an NPI since 2007.

Licensed in
WI
In the registry since
2007
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

10850 W Park Pl Ste # 100
Milwaukee, WI 53224-3606
Phone: (262) 542-3255
Fax: (414) 359-1021
Show map & directions

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

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 2578-123 (WI)

Record details

NPI number1477610285
Entity typeIndividual (Type 1)
GenderMale
Credentials LCSW
Sole proprietorNo
NPI enumeratedJanuary 2, 2007
Last updated in NPPESJuly 8, 2007

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