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

Michelle Wallace, LCSW

Individual provider Mental Health Counselor · NPI 1336796374

Michelle Wallace, LCSW is a Mental Health Counselor in Bend, Oregon. Licensed in Oregon. Registered with an NPI since 2019.

Licensed in
OR
In the registry since
2019
Specialties on file
2
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

1340 NW Wall St
Bend, OR 97703-1985
Phone: (541) 322-7500
Fax: (541) 322-7565
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence L11322 (OR)
Mental Health Counselor Taxonomy 101YM0800X

Record details

NPI number1336796374
Entity typeIndividual (Type 1)
GenderFemale
Credentials LCSW
Sole proprietorNo
NPI enumeratedAugust 23, 2019
Last updated in NPPESApril 17, 2023
Certification dateApril 17, 2023
Mailing address2577 Ne Courtney Dr, Bend, OR 97701-7752

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