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

Tamika Shavone Wallace, LCSW-A

Individual provider Clinical Social Worker · NPI 1629415070

Tamika Shavone Wallace, LCSW-A is a Clinical Social Worker in Fayetteville, North Carolina. Licensed in North Carolina. Registered with an NPI since 2013.

Licensed in
NC
In the registry since
2013

Practice location Address checks out

511 Middle Rd
Fayetteville, NC 28312-5207
Phone: (910) 584-3564
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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 P009482 (NC)

Record details

NPI number1629415070
Entity typeIndividual (Type 1)
GenderFemale
Credentials LCSW-A
Sole proprietorNo
NPI enumeratedMay 24, 2013
Last updated in NPPESMay 19, 2015

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