NICHOLE WALLACE
NPI 1407546229
Social Worker - Clinical in Grand Rapids, MI

Active since May 15, 2023
678 FRONT AVE NW STE 100, GRAND RAPIDS, MI 49504(616) 916-3711 Get Directions Write a Review

NPPES record last updated: May 15, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Nichole Wallace NPPES

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

NICHOLE WALLACE (NPI 1407546229) is an individual clinical provider in Grand Rapids, Michigan, licensed in Michigan (6851116253) and active in the NPI registry since May 2023.

NPPES Registry Identity

NPI1407546229
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameNICHOLE WALLACE
Location Address678 FRONT AVE NW STE 100Grand Rapids, MI 49504-5323
Mailing Address101 Fuller Ave SeGrand Rapids, MI 49506-1635
Sole ProprietorYes
Enumeration DateMay 15, 2023
NPPES CertifiedMay 15, 2023
NPI 1407546229 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 MI · 6851116253
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.
678 FRONT AVE NW STE 100, Grand Rapids, MI 49504

Other Providers at the Same Location NPPES 11

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

Social Worker
678 FRONT AVE NW STE 100
GRAND RAPIDS, MI 49504
Counselor (Professional)
678 FRONT AVE NW STE 100
GRAND RAPIDS, MI 49504
Social Worker (Clinical)
678 FRONT AVE NW STE 100
GRAND RAPIDS, MI 49504
Counselor (Mental Health)
678 FRONT AVE NW STE 100
GRAND RAPIDS, MI 49504
Counselor
678 FRONT AVE NW STE 100
GRAND RAPIDS, MI 49504
Counselor (Professional)
678 FRONT AVE NW STE 100
GRAND RAPIDS, MI 49504
Counselor (Mental Health)
678 FRONT AVE NW STE 100
GRAND RAPIDS, MI 49504
Social Worker (Clinical)
678 FRONT AVE NW STE 100
GRAND RAPIDS, MI 49504

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 Nichole Wallace's NPI number?

The NPI number for Nichole Wallace is 1407546229. It was assigned to this individual provider in the NPPES registry on May 15, 2023.

Where is Nichole Wallace located?

Nichole Wallace practices at 678 Front Ave NW Ste 100, Grand Rapids, MI 49504. The listed phone number is (616) 916-3711.

What is Nichole 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 Nichole Wallace was last updated on May 15, 2023. 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.