IndividualActive
Bethany Wallace, LCSW
NPI 1992987754 · Clinical Social Worker · Salem, OR
Bethany Wallace, LCSW is a Clinical Social Worker provider in Salem, OR (NPI 1992987754).
Provider details
- NPI number
- 1992987754
- Entity type
- Individual
- Primary specialty
- Clinical Social WorkerBehavioral Health & Social Service Providers
- Credential
- LCSW
- Sex
- Female
- Sole proprietor
- No
- License
- 5807 (OR)
Practice location
2450 Lancaster Dr Ne
Salem, OR 97305-1130
Phone: (503) 783-4004
Street-level locationGet directions
Mailing address
3624 Commercial St Se Unit 4364
Salem, OR 97302-6712
Registry dates
- Enumerated
- 2007-12-03
- Last updated
- 2025-06-02
- Certified
- 2025-06-02
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.