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

Mrs. Chulete Aurielle Wallace-Keane, LCSW

Individual provider Clinical Social Worker · NPI 1962894485

Mrs. Chulete Aurielle Wallace-Keane, LCSW is a Clinical Social Worker in Moody AFB, Georgia. Licensed in North Carolina. Registered with an NPI since 2015.

Licensed in
NC
In the registry since
2015
Specialties on file
2
What do these letters mean?
LCSW — Licensed Clinical Social Worker
A social worker licensed to diagnose and treat mental health conditions independently.

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Practice location Address checks out

3280 Mitchell Blvd
Moody AFB, GA 31699-1500
Phone: (229) 257-2778
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence C010976 (NC)
Clinical Social Worker Taxonomy 1041C0700X

Record details

NPI number1962894485
Entity typeIndividual (Type 1)
GenderFemale
Credentials LCSW
Sole proprietorNo
NPI enumeratedFebruary 20, 2015
Last updated in NPPESDecember 4, 2023
Certification dateDecember 4, 2023

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