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

Individual provider Social Worker · NPI 1275821993

Nicole M. Wallace, MSW, LCSW is a Social Worker in Huntington, New York. Works from 2 locations. Licensed in New York.

Licensed in
NY
In the registry since
2011
Specialties on file
2
What do these letters mean?
MSW — Master of Social Work
The graduate degree in social work.
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

177 Main St Ste 206
Huntington, NY 11743-6917
Phone: (631) 380-3454
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 180 Livingston St, Brooklyn, NY 11201-5861 — (347) 328-8110

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 084663 (NY)
Social Worker Taxonomy 104100000X · Licence 084063 (NY)

Record details

NPI number1275821993
Entity typeIndividual (Type 1)
GenderFemale
Credentials MSW , LCSW
Sole proprietorNo
NPI enumeratedJuly 15, 2011
Last updated in NPPESMarch 17, 2018

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