Individual
CHRISTOPHER SCOTT WALLACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
101 N 1ST AVE STE 2325, PHOENIX, AZ 85003-1933
(480) 569-1604
Mailing address
101 N 1ST AVE STE 2325, PHOENIX, AZ 85003-1933
(770) 714-9847
(757) 953-6091
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
0904009872
VA
1041C0700X
Clinical Social Worker
17443
MD
1041C0700X
Clinical Social Worker
Primary
22821
AZ
Other
Enumeration date
03/28/2017
Last updated
04/05/2025
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