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Individual

CHRISTOPHER JAMES WALLACE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LCPC-C, CADC

Contact information

Practice address
420 CUMBERLAND AVE, PORTLAND, ME 04101-2823
(207) 775-5671
Mailing address
16 ARCADIA DR, WINDHAM, ME 04062-5263
(207) 615-1014

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
CAC8987
ME
101YP2500X
Professional Counselor
Primary
XL8138
ME

Other

Enumeration date
05/20/2025
Last updated
07/09/2025
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