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MRS. STACY GARRETT WALLACE LCSW
NPI 1225754120
Social Worker - Clinical in Tyrone, GA

Active since October 13, 2022
105 SAINT STEPHENS CT, TYRONE, GA 30290(770) 378-9913 Get Directions Write a Review

NPPES record last updated: October 13, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Mrs. Stacy Garrett Wallace Lcsw NPPES

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

MRS. STACY GARRETT WALLACE LCSW (NPI 1225754120) is an individual clinical provider in Tyrone, Georgia, licensed in Georgia (CSW002388) and active in the NPI registry since October 2022.

NPPES Registry Identity

NPI1225754120
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameMRS. STACY GARRETT WALLACECredential: LCSW
Location Address105 SAINT STEPHENS CTTyrone, GA 30290-1716
Mailing Address74 Price Dr WLocust Grove, GA 30248-2540 · (770) 378-9913
Phone(770) 378-9913
Sole ProprietorNo
Enumeration DateOctober 13, 2022
NPPES CertifiedOctober 13, 2022
✔ NPI 1225754120 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License✔ Licensed in GA · CSW002388
Definition
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
105 SAINT STEPHENS CT, Tyrone, GA 30290
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Other Providers at the Same Location NPPES

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

R&K MEDCAL WEIGHT LOSS CLINIC
Clinic/Center (Medical Specialty)
105 SAINT STEPHENS CT, SUITE F
TYRONE, GA 30290
Fayette County (770) 964-0611

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 Stacy Wallace's NPI number?

The NPI number for Stacy Wallace is 1225754120. It was assigned to this individual provider in the NPPES registry on October 13, 2022.

Where is Stacy Wallace located?

Stacy Wallace practices at 105 Saint Stephens Ct, Tyrone, GA 30290. The listed phone number is (770) 378-9913.

What is Stacy Wallace's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

When was this NPI record last updated?

The NPPES record for Stacy Wallace was last updated on October 13, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.