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

Mr. Darrell Dewayne Wallace Jr., LGPC

Individual provider Mental Health Counselor · NPI 1265086367

Mr. Darrell Dewayne Wallace Jr., LGPC is a Mental Health Counselor in Baltimore, Maryland. Practices as a sole proprietor. Licensed in Maryland.

Licensed in
MD
In the registry since
2019

Practice location Address checks out

107 E 25th St
Baltimore, MD 21218-5213
Phone: (410) 558-0019
Show map & directions

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

Specialties & licences

Mental Health Counselor (primary) Taxonomy 101YM0800X · Licence LGP9687 (MD)

Record details

NPI number1265086367
Entity typeIndividual (Type 1)
GenderMale
Credentials LGPC
Sole proprietorYes
NPI enumeratedJuly 26, 2019
Last updated in NPPESJuly 26, 2019

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