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

Miss. Bethany Wallace, LCSW

Individual provider Clinical Social Worker · NPI 1003388455

Miss. Bethany Wallace, LCSW is a Clinical Social Worker in Fort Worth, Texas. Licensed in Texas. Registered with an NPI since 2018.

Licensed in
TX
In the registry since
2018
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

4686 Bristol Trace Trl
Fort Worth, TX 76244-6947
Phone: (817) 705-1586
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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 61687 (TX)

Record details

NPI number1003388455
Entity typeIndividual (Type 1)
GenderFemale
Credentials LCSW
Sole proprietorNo
NPI enumeratedDecember 26, 2018
Last updated in NPPESDecember 26, 2018

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