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TY'CRISTIAN Q. WALLACE LGPC, CAC-ADS
NPI 1255053609
Counselor - Mental Health in Baltimore, MD

Active since September 13, 2022
638 N GILMOR ST, BALTIMORE, MD 21217(410) 462-2268 Get Directions Write a Review

NPPES record last updated: March 5, 2026. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Mar 5, 2026, Sep 13, 2022 (2 updates tracked since 2022).

About Ty'cristian Q. Wallace Lgpc, Cac-ads NPPES

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

TY'CRISTIAN Q. WALLACE LGPC, CAC-ADS (NPI 1255053609) is an individual mental health provider in Baltimore, Maryland, licensed in Maryland (LGP15614) and active in the NPI registry since September 2022. He maintains a secondary practice location in Cambridge.

NPPES Registry Identity

NPI1255053609
Entity TypeIndividualMale
Primary Taxonomy101YM0800X
Provider Legal NameTY'CRISTIAN Q. WALLACECredential: LGPC, CAC-ADS
Location Address638 N GILMOR STBaltimore, MD 21217-2101
Mailing Address2902 Dunmore Rd Apt ADundalk, MD 21222-5125 · (443) 845-4639
Phone(410) 462-2268
Sole ProprietorNo
Enumeration DateSeptember 13, 2022
Last NPPES UpdateMarch 5, 20262 updates tracked since enumeration
NPPES CertifiedMarch 5, 2026
✔ NPI 1255053609 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
License✔ Licensed in MD · LGP15614
Also ListedCounselor · Addiction (Substance Use Disorder)Taxonomy 101YA0400X · License AC3232 (MD)
638 N GILMOR ST, Baltimore, MD 21217
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Secondary Practice Location 1

Location 1829 Fieldcrest RdCambridge, MD 21613-9423 · Phone (410) 228-8101

Other Providers at the Same Location NPPES 7

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

ALISA CARTER LGPC
Counselor (Mental Health)
638 N GILMOR ST
BALTIMORE, MD 21217
Baltimore City (410) 462-2268
ABOVE IT ALL
Clinic/Center (Recovery Care)
638 N GILMOR ST
BALTIMORE, MD 21217
Baltimore City (410) 462-2268
ABOVE IT ALL
Clinic/Center (Mental Health (Including Community Mental Health Center))
638 N GILMOR ST
BALTIMORE, MD 21217
Baltimore City (410) 462-2268
TAMIYANA D LYNCH
Counselor (Professional)
638 N GILMOR ST
BALTIMORE, MD 21217
Baltimore City (410) 462-2268
MORGAN SYMONE ANDERSON
Social Worker (Clinical)
638 N GILMOR ST
BALTIMORE, MD 21217
Baltimore City (410) 462-2268
ABOVE IT ALL
Counselor (Mental Health)
638 N GILMOR ST
BALTIMORE, MD 21217
Baltimore City (410) 462-2268
ABOVE IT ALL
Community/Behavioral Health
638 N GILMOR ST
BALTIMORE, MD 21217
Baltimore City (410) 340-8824

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 Ty'cristian Wallace's NPI number?

The NPI number for Ty'cristian Wallace is 1255053609. It was assigned to this individual provider in the NPPES registry on September 13, 2022.

Where is Ty'cristian Wallace located?

Ty'cristian Wallace practices at 638 N Gilmor St, Baltimore, MD 21217. The listed phone number is (410) 462-2268.

What is Ty'cristian Wallace's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

When was this NPI record last updated?

The NPPES record for Ty'cristian Wallace was last updated on March 5, 2026, 4 months ago. NPI Profile syncs with the weekly NPPES data releases published by CMS; the most recent full sync was completed on July 26, 2026. 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.