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

Mrs. Connie Lee Wallace, LPCC-S, CTT

Individual provider Mental Health Counselor · NPI 1386668200

Mrs. Connie Lee Wallace, LPCC-S, CTT is a Mental Health Counselor in Dover, Ohio. Qualified in 1986, 40 years ago. Practices as a sole proprietor and accepts Medicare assignment. Licensed in Ohio.

Years since qualifying
40
Licensed in
OH
In the registry since
2006
Specialties on file
2

Practice location Address checks out

547 1/2 S James St Ste A
Dover, OH 44622-2137
Phone: (330) 343-7400
Fax: (330) 343-7414
Show map & directions

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

Specialties & licences

Mental Health Counselor (primary) Taxonomy 101YM0800X · Licence E0001636-SUPV (OH)
Professional Counselor Taxonomy 101YP2500X · Licence E0001636-SUPV (OH)

Record details

NPI number1386668200
Entity typeIndividual (Type 1)
GenderFemale
Credentials LPCC-S , CTT
Sole proprietorYes
NPI enumeratedJuly 26, 2006
Last updated in NPPESFebruary 16, 2016

Medicare enrollment

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

Medicare specialtyMENTAL HEALTH COUNSELOR
Medical schoolOTHER
Graduated 1986 (40 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Dover