Lisa M Wallace
MA, LPC | Professional Counselor
4103 E Boardwalk Drive, Suite 202, Fort Collins
Colorado, 80525-5930
970-817-4049 877-833-4460
Maps & DirectionsLisa M Wallace is a Fort Collins, Colorado based counselor who is specialized as Professional Counselor. Active license number of Lisa M Wallace is 5913 for Professional Counselor in Colorado. Her current practice location is 4103 E Boardwalk Drive, Suite 202, Fort Collins. Patients can book an appointment with her at 970-817-4049.
Lisa M Wallace is a licensed mental health practitioner trained to help individuals, couples, and groups address emotional, psychological, and behavioral challenges. She uses talk therapy and evidence-based counseling methods to support clients in managing mental health conditions, improving relationships, and developing coping strategies for life’s difficulties.
Complete Profile:
Lisa M Wallace speciality, credentials, practice address, contact phone number and fax are as below.
Patients can directly walk in or can call on the below given phone number for appointment.
| Name: | Lisa M Wallace |
| Specialization: | Professional Counselor |
| Gender: | Female |
| Credentials: | MA, LPC |
| Accepts Medicare Assignment: | No |
| Practice Address: | 4103 E Boardwalk Drive, Suite 202, Fort Collins,
Colorado, 80525-5930 |
| Phone: | 970-817-4049 |
| Fax: | 877-833-4460 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details are as mentioned below.
| NPI Number: | 1124002571 |
| NPI Enumeration Date: | 30 Nov, 2005 |
| NPI Last Update On: | 01 Dec, 2025 |
Medical Licenses:
Doctors can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Lisa M Wallace are as mentioned below.
| License Number | Specialization | State | Status | |
| 5913 | Professional Counselor | Colorado | Primary | |
| 906 | Professional Counselor | Wyoming | Secondary | |
Other Medical Identifiers:
Other legacy medical identifiers associated with Lisa M Wallace such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
| Identifier | Type | State | Issuer |
| 312410 | Other | Wyoming | BS OF WY |
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | Po Box 273338,
Fort Collins, Colorado |
| Zip: | 80527-3338 |
| Phone Number: | 970-817-4049 |
| Fax Number: | 877-833-4460 |
Patients can reach Lisa M Wallace at
4103 E Boardwalk Drive, Suite 202, Fort Collins, Colorado or can
call to book an appointment on 970-817-4049.
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Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 09 February, 2026.