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

Mr. Wallace Edward Brandies Jr., CSACICS

Individual provider Addiction (Substance Use Disorder) Counselor · NPI 1811595671

Mr. Wallace Edward Brandies Jr., CSACICS is an Addiction (Substance Use Disorder) Counselor in Racine, Wisconsin. Licensed in Wisconsin. Registered with an NPI since 2020.

Licensed in
WI
In the registry since
2020

Practice location Address checks out

1717 Taylor Ave
Racine, WI 53403-2405
Phone: (262) 638-6635
Fax: (262) 638-6540
Show map & directions

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

Specialties & licences

Addiction (Substance Use Disorder) Counselor (primary) Taxonomy 101YA0400X · Licence 15295-132 (WI)

Record details

NPI number1811595671
Entity typeIndividual (Type 1)
GenderMale
Credentials CSACICS
Sole proprietorNo
NPI enumeratedOctober 14, 2020
Last updated in NPPESOctober 14, 2020
Certification dateOctober 14, 2020

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