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

Individual provider Clinical Social Worker · NPI 1962843417

Priscilla Wallace is a Clinical Social Worker in Detroit, Michigan. Practices as a sole proprietor. Licensed in Michigan.

Licensed in
MI
In the registry since
2013
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Practice location Address checks out

2051 W Grand Blvd
Detroit, MI 48208-1105
Phone: (313) 961-3200
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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 6802086262 (MI)

Record details

NPI number1962843417
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedJuly 12, 2013
Last updated in NPPESJuly 12, 2013

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