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JENNIFER DAWN WALLACE LPCC/S
NPI 1174158976
Counselor - Professional in Georgetown, KY

Active since March 12, 2020
204 BEVINS LN STE A, GEORGETOWN, KY 40324(859) 951-9777(859) 951-9779 Get Directions Write a Review

NPPES record last updated: November 20, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Nov 20, 2020, Jun 22, 2020, Mar 12, 2020 (3 updates tracked since 2020).

About Jennifer Dawn Wallace Lpcc/s NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JENNIFER DAWN WALLACE LPCC/S (NPI 1174158976) is an individual professional provider in Georgetown, Kentucky, licensed in (104157) and active in the NPI registry since March 2020. She maintains a secondary practice location in Georgetown.

NPPES Registry Identity

NPI1174158976
Entity TypeIndividualFemale
Primary Taxonomy101YP2500X
Provider Legal NameJENNIFER DAWN WALLACECredential: LPCC/S
Location Address204 BEVINS LN STE AGeorgetown, KY 40324-6145
Mailing Address204 Bevins Ln Ste AGeorgetown, KY 40324-6145 · (859) 951-9777 · Fax (859) 951-9779
Phone(859) 951-9777
Fax(859) 951-9779
Sole ProprietorNo
Enumeration DateMarch 12, 2020
Last NPPES UpdateNovember 20, 20203 updates tracked since enumeration
NPPES CertifiedNovember 20, 2020
✔ NPI 1174158976 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
License✔ Licensed · 104157
Also ListedCounselorTaxonomy 101Y00000X · License 104157 (KY)
204 BEVINS LN STE A, Georgetown, KY 40324
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Secondary Practice Location 1

Location 1200 Bevins Ln Ste EGeorgetown, KY 40324-8532 · Phone (859) 951-9777

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CALEB MACKEY LPCC
Counselor (Professional)
204 BEVINS LN STE A
GEORGETOWN, KY 40324
Scott County (859) 951-9777
JEFFREY ALAN CHAPMAN LCSW
Social Worker (Clinical)
204 BEVINS LN STE A
GEORGETOWN, KY 40324
Scott County (859) 951-9777
LAUREN POLLY LCSW
Social Worker
204 BEVINS LN STE A
GEORGETOWN, KY 40324
Scott County (859) 951-9777
OSAMA ALI M.D.
Psychiatry & Neurology (Psychiatry)
204 BEVINS LN STE A
GEORGETOWN, KY 40324
Scott County (502) 603-9881
LESA YOUNG COUNSELING, LLC
Counselor (Mental Health)
204 BEVINS LN STE A
GEORGETOWN, KY 40324
Scott County (859) 951-9777

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jennifer Wallace's NPI number?

The NPI number for Jennifer Wallace is 1174158976. It was assigned to this individual provider in the NPPES registry on March 12, 2020.

Where is Jennifer Wallace located?

Jennifer Wallace practices at 204 Bevins Ln Ste A, Georgetown, KY 40324. The listed phone number is (859) 951-9777.

What is Jennifer Wallace's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

When was this NPI record last updated?

The NPPES record for Jennifer Wallace was last updated on November 20, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.