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

Mrs. Bonita Lucille Wallace, LPC

Individual provider Professional Counselor · NPI 1912364787

Mrs. Bonita Lucille Wallace, LPC is a Professional Counselor in Atlanta, Georgia. Practices as a sole proprietor. Licensed in Georgia.

Licensed in
GA
In the registry since
2016
What do these letters mean?
LPC — Licensed Professional Counselor
A licensed mental health counsellor.

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Practice location Address checks out

550 Pharr Rd NE Ste 605
Atlanta, GA 30305-3428
Phone: (404) 664-6398
Fax: (678) 705-2758
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Professional Counselor (primary) Taxonomy 101YP2500X · Licence 1823 (GA)

Record details

NPI number1912364787
Entity typeIndividual (Type 1)
GenderFemale
Credentials LPC
Sole proprietorYes
NPI enumeratedJanuary 25, 2016
Last updated in NPPESJanuary 25, 2016

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