Dylan Wallace, LCSW, QCSW in Plymouth, MA - Medicare Social Worker Provider

Dylan Wallace, LCSW, QCSW is a medicare enrolled "Social Worker - Clinical" provider in Plymouth, Massachusetts. His current practice location is 34 Main Street Ext Ste 104, Plymouth, Massachusetts. You can reach out to his office (for appointments etc.) via phone at (801) 655-5450.

Dylan Wallace is licensed to practice in Utah (license number 11338410-3501) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1982269155.

Contact Information

	Dylan Wallace, LCSW, QCSW
	34 Main Street Ext Ste 104, Plymouth, MA 02360-3375
	(801) 655-5450
	(385) 225-9327

Map and Direction

Healthcare Provider's Profile

Full Name	Dylan Wallace
Gender	Male
Speciality	Social Worker - Clinical
Location	34 Main Street Ext Ste 104, Plymouth, Massachusetts
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1982269155
Provider Enumeration Date: 05/03/2019
Last Update Date: 12/30/2024

Medicare PECOS Information:

PECOS PAC ID: 3173060076
Enrollment ID: I20240808001881

Medical Identifiers

Medical identifiers for Dylan Wallace such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1982269155	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
1041C0700X	Social Worker - Clinical	SW15210 (Florida)	Secondary
1041C0700X	Social Worker - Clinical	LCSW-22060 (Arizona)	Secondary
1041C0700X	Social Worker - Clinical	LICSW126861 (Massachusetts)	Secondary
1041C0700X	Social Worker - Clinical	LW61224850 (Washington)	Secondary
1041C0700X	Social Worker - Clinical	11338410-3501 (Utah)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dylan Wallace allows following entities to bill medicare on his behalf.

Entity Name	Meadowbrook Counseling Of Massachusetts Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1689445488 PECOS PAC ID: 8426595406 Enrollment ID: O20240808001174

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dylan Wallace is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Dylan Wallace, LCSW, QCSW 1469 N 1200 W, Orem, UT 84057-2449 Ph: (801) 655-5450	Dylan Wallace, LCSW, QCSW 34 Main Street Ext Ste 104, Plymouth, MA 02360-3375 Ph: (801) 655-5450

Reviews and Comments

Social Worker in Plymouth, MA

Mrs. Nicole S. Morrison, LICSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 3 Market Xing, Plymouth, MA 02360 Phone: 781-361-5711 Fax: 508-224-2550
Dr. Claudia Orfao-martin, LICSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 39a Industrial Park Rd Lowr Level, Duxbury Counseling Center, Northeast Health, Plymouth, MA 02360 Phone: 508-830-1444 Fax: 508-830-3655
Tara Whooley, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 900 Ship Pond Rd, Plymouth, MA 02360 Phone: 508-209-6344
Sarah Blais, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 275 Sandwich St, Plymouth, MA 02360 Phone: 508-830-2142 Fax: 508-732-8688
Loryn Traversi-irwin, Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 100 Armstrong Rd, Plymouth, MA 02360 Phone: 508-209-4438
Emily Walsh, LICSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 64 Industrial Park Rd, Plymouth, MA 02360 Phone: 508-747-7032
Mrs. Julia Gordon, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 50 Aldrin Rd, Plymouth, MA 02360 Phone: 508-830-0000

Dylan Wallace, LCSW, QCSW - Medicare Clinical Social Worker in Plymouth, MA