Kati Wallace, is a
Social Worker - Clinical based in Cloverdale, Indiana. Kati Wallace is licensed to practice in Indiana (license number 34010387A) and her current practice location is
3 W Boone St, Cloverdale, Indiana. She can be reached at her office (for appointments etc.) via phone at
(812) 605-9748.
NPI number for Kati Wallace is 1245072073 and her current mailing address is 3 W Boone St, Cloverdale, Indiana. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1245072073.
Healthcare Provider's Profile
| Full Name | Kati Wallace |
|---|
| Gender | Female |
|---|
| Speciality | Social Worker - Clinical |
|---|
| Location | 3 W Boone St, Cloverdale, Indiana |
|---|
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
NPI Data:
- NPI Number: 1245072073
- Provider Enumeration Date: 06/11/2024
- Last Update Date: 10/03/2025
Medical Identifiers
Medical identifiers for Kati Wallace such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1245072073 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 1041C0700X | Social Worker - Clinical | 34010387A (Indiana) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Kati Wallace is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
Kati Wallace, 3 W Boone St, Cloverdale, IN 46120-9003 Ph: (812) 605-9748 | Kati Wallace, 3 W Boone St, Cloverdale, IN 46120-9003 Ph: (812) 605-9748 |
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