| Dana J. Wallace, Lcsw, Llc | |
|
480 Santa Rosa Blvd Unit 308e Fort Walton Beach FL 32548-6945 | |
| (251) 421-0712 | |
| Not Available |
| Full Name | Dana J. Wallace, Lcsw, Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 480 Santa Rosa Blvd Unit 308e, Fort Walton Beach, Florida |
| Authorized Official Name and Position | Dana Janelle Wallace (SOCIAL WORKER/PSYCHTHERAPIST) |
| Authorized Official Contact | 2514210712 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dana J. Wallace, Lcsw, Llc 480 Santa Rosa Blvd Unit 308e Fort Walton Beach FL 32548-6945 Ph: (251) 421-0712 | Dana J. Wallace, Lcsw, Llc 480 Santa Rosa Blvd Unit 308e Fort Walton Beach FL 32548-6945 Ph: (251) 421-0712 |
| NPI Number | 1457280828 |
|---|---|
| Provider Enumeration Date | 05/14/2026 |
| Last Update Date | 05/14/2026 |
| Certification Date | 05/13/2026 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457280828 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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