Organization
GARY WALLER LCSW LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GARY DWIGHT WALLER LCSW (OWNER/ THERAPIST)
(601) 749-9477
Entity
Organization
Contact information
Practice address
1839 COOPER RD STE D, PICAYUNE, MS 39466-2836
(601) 749-9477
(601) 749-0605
Mailing address
1839 COOPER RD STE D, PICAYUNE, MS 39466-2836
(601) 749-9477
(601) 749-0605
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
03/17/2026
Last updated
03/17/2026
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