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

Mr. Jeffrey Eugene Wallace, LICSW, MSW, CDP, MHP

Individual provider Clinical Social Worker · NPI 1538557012

Mr. Jeffrey Eugene Wallace, LICSW, MSW, CDP, MHP is a Clinical Social Worker in Spokane, Washington. Qualified in 2014, 12 years ago. Practices as a sole proprietor, works from 2 locations, accepts Medicare assignment and offers telehealth. Licensed in Washington.

Years since qualifying
12
Licensed in
WA
In the registry since
2015
Specialties on file
3
What do these letters mean?
LICSW — Licensed Independent Clinical Social Worker
The title some states use for an independently practising clinical social worker.
MSW — Master of Social Work
The graduate degree in social work.

See every abbreviation used in this directory →

Claim this listing Report a problem Suggest an edit

Practice location Address checks out

400 S Jefferson St Ste 200
Spokane, WA 99204-3143
Phone: (509) 822-8662
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

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

Additional practice locations (1)

  • 22 S. Thor St., Spokane, WA 99202 — (509) 532-2000

Specialties & licences

Mental Health Counselor (primary) Taxonomy 101YM0800X · Licence SC60493319 (WA)
Clinical Social Worker Taxonomy 1041C0700X · Licence SC60493319 (WA)
Addiction (Substance Use Disorder) Counselor Taxonomy 101YA0400X · Licence CO60490069 (WA)

Record details

NPI number1538557012
Entity typeIndividual (Type 1)
GenderMale
Credentials LICSW , MSW , CDP , MHP
Sole proprietorYes
NPI enumeratedJanuary 6, 2015
Last updated in NPPESJanuary 28, 2019

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2014 (12 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

Other providers in Spokane