NPI
Evan C Wallace
NPI 1770329583
Read from the NPPES registry on October 24, 2026.
Facts
- Status
- Active
- Credential
- LMSW
- Type
- Individual
- Enumeration date
- 2024-07-02
- Last updated
- 2024-07-02
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Specialties
Licenses
- License MO
- 2024022765
Location
- Practice location
- 154 Forrest Dr
- City
- Hannibal MO
- Postal code
- 63401-5511
- Phone
- (573) 221-2120
- Fax
- (573) 221-4380
Medicare
- PECOS
- No PECOS enrollment row matched this NPI.
LEIE
No exclusion found for this NPI in the OIG LEIE file dated October 9, 2026. Confirm on OIG's online search.
Nearby
Clinical Social Workers in Hannibal, MO. 29 with this primary taxonomy in the public file.
Other NPIs in Hannibal, MO. 779 records in the public file.
Public data from NPPES and CMS. Not a credentialing determination.
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