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Contact Information

DEBORAH F WALLACE, LCPC LICENSED CLINIC
18772 RT. 4
CARLINVILLE, IL62626
 Phone: 217-854-2712
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Professional

101YP2500X
Indicates primary specialty

NPI Profile & details for DEBORAH F WALLACE · (Female)

NPI Number 1235999293
Status Active
Credentials LCPC LICENSED CLINIC
Entity Individual
Enumeration date 03/19/2024
Last updated 03/19/2024 - About 2 years ago
Sole proprietor 1 No
Identifiers
  • IL License # 180.003816
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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