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MR. NICHOLAS PRESTON WALLACE LPC, NCC, CCMHC
NPI 1356747430
Counselor - Professional in Bossier City, LA

Active since November 17, 2014
90 KINGSTON XING APT 1506, BOSSIER CITY, LA 71111(318) 935-0105 Get Directions Write a Review

NPPES record last updated: June 6, 2021. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Jun 6, 2021, Nov 3, 2016 (2 updates tracked since 2016).

About Mr. Nicholas Preston Wallace Lpc, Ncc, Ccmhc NPPES

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

MR. NICHOLAS PRESTON WALLACE LPC, NCC, CCMHC (NPI 1356747430) is an individual professional provider in Bossier City, Louisiana, licensed in Louisiana (LPC #5493) and active in the NPI registry since November 2014.

NPPES Registry Identity

NPI1356747430
Entity TypeIndividualMale
Primary Taxonomy101YP2500X
Provider Legal NameMR. NICHOLAS PRESTON WALLACECredential: LPC, NCC, CCMHC
Location Address90 KINGSTON XING APT 1506Bossier City, LA 71111-6289
Mailing Address90 Kingston Xing Apt 1506Bossier City, LA 71111-6289 · (318) 210-8499
Phone(318) 935-0105
Sole ProprietorYes
Enumeration DateNovember 17, 2014
Last NPPES UpdateJune 6, 20212 updates tracked since enumeration
NPPES CertifiedJune 6, 2021
✔ NPI 1356747430 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 in LA · LPC #5493
Also ListedCounselor · Mental HealthTaxonomy 101YM0800X · License LPC #5493 (LA)
90 KINGSTON XING APT 1506, Bossier City, LA 71111
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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 Nicholas Wallace's NPI number?

The NPI number for Nicholas Wallace is 1356747430. It was assigned to this individual provider in the NPPES registry on November 17, 2014.

Where is Nicholas Wallace located?

Nicholas Wallace practices at 90 Kingston Xing Apt 1506, Bossier City, LA 71111. The listed phone number is (318) 935-0105.

What is Nicholas 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 Nicholas Wallace was last updated on June 6, 2021. NPI Profile syncs with the weekly NPPES data releases published by CMS.