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

Individual provider Professional Counselor · NPI 1306224613

Tracie Wallace, LPC is a Professional Counselor in Saint Louis, Missouri. Practices as a sole proprietor. Licensed in Missouri.

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

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Practice location Address checks out

1023 Executive Parkway Dr Ste 10
Saint Louis, MO 63141-6323
Phone: (314) 469-5522
Fax: (314) 469-5504
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Professional Counselor (primary) Taxonomy 101YP2500X · Licence 2012029763 (MO)

Record details

NPI number1306224613
Entity typeIndividual (Type 1)
GenderFemale
Credentials LPC
Sole proprietorYes
NPI enumeratedMay 7, 2015
Last updated in NPPESMay 7, 2015

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