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

MS. Kimberly Wallace, LPC

Individual provider Professional Counselor · NPI 1083091987

MS. Kimberly Wallace, LPC is a Mental Health Counselor in Marietta, Georgia. Qualified in 2012, 14 years ago. Practices as a sole proprietor and accepts Medicare assignment. Licensed in Georgia.

Years since qualifying
14
Licensed in
GA
In the registry since
2015
What do these letters mean?
LPC — Licensed Professional Counselor
A licensed mental health counsellor.

See every abbreviation used in this directory →

Claim this listing Report a problem Suggest an edit

Practice location Address checks out

2852 Johnson Ferry Rd Ste 100
Marietta, GA 30062-5686
Phone: (404) 906-9831
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

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

Specialties & licences

Professional Counselor (primary) Taxonomy 101YP2500X · Licence LPC008384 (GA)

Record details

NPI number1083091987
Entity typeIndividual (Type 1)
GenderFemale
Credentials LPC
Sole proprietorYes
NPI enumeratedApril 29, 2015
Last updated in NPPESNovember 24, 2023
Certification dateNovember 24, 2023
Mailing address2852 Johnson Ferry Rd Ste 100, Marietta, GA 30062-5686

Medicare enrollment

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

Medicare specialtyMENTAL HEALTH COUNSELOR
Medical schoolOTHER
Graduated 2012 (14 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Marietta