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

Mr. John Jason Wallace, LCSW

Individual provider Clinical Social Worker · NPI 1063652097

Mr. John Jason Wallace, LCSW is a Clinical Social Worker in Wilkes Barre, Pennsylvania. Licensed in Pennsylvania. Registered with an NPI since 2009.

Licensed in
PA
In the registry since
2009
What do these letters mean?
LCSW — Licensed Clinical Social Worker
A social worker licensed to diagnose and treat mental health conditions independently.

See every abbreviation used in this directory →

Practice location Address checks out

1111 E End Blvd
Wilkes Barre, PA 18711-0030
Phone: (570) 824-3521
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 CW015384 (PA)

Record details

NPI number1063652097
Entity typeIndividual (Type 1)
GenderMale
Credentials LCSW
Sole proprietorNo
NPI enumeratedMarch 4, 2009
Last updated in NPPESMarch 4, 2009

Other providers in Wilkes Barre