Mr Jeffrey Eugene Wallace, LICSW, MSW, CDP, MHP is a medicare enrolled "Counselor - Mental Health" provider in Spokane, Washington. He graduated from medical school in 2014 and has 11 years of diverse experience with area of expertise as Clinical Social Worker. His current practice location is
400 S Jefferson St Ste 200, Spokane, Washington. You can reach out to his office (for appointments etc.) via phone at
(509) 822-8662.
Mr Jeffrey Eugene Wallace is licensed to practice in Washington (license number SC60493319) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1538557012.
Healthcare Provider's Profile
| Full Name | Mr Jeffrey Eugene Wallace |
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| Gender | Male |
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| Speciality | Clinical Social Worker |
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| Experience | 11 Years |
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| Location | 400 S Jefferson St Ste 200, Spokane, Washington |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Mr Jeffrey Eugene Wallace graduated from medical school in 2014
NPI Data:
- NPI Number: 1538557012
- Provider Enumeration Date: 01/06/2015
- Last Update Date: 01/28/2019
Medicare PECOS Information:
- PECOS PAC ID: 6901340884
- Enrollment ID: I20240702003499
Medical Identifiers
Medical identifiers for Mr Jeffrey Eugene Wallace such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1538557012 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 1041C0700X | Social Worker - Clinical | SC60493319 (Washington) | Secondary |
| 101YM0800X | Counselor - Mental Health | SC60493319 (Washington) | Primary |
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | CO60490069 (Washington) | Secondary |
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. Mr Jeffrey Eugene 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 |
|---|
Mr Jeffrey Eugene Wallace, LICSW, MSW, CDP, MHP
400 S Jefferson St Ste 200,
Spokane, WA 99204-3143
Ph: (509) 822-8662 | Mr Jeffrey Eugene Wallace, LICSW, MSW, CDP, MHP
400 S Jefferson St Ste 200,
Spokane, WA 99204-3143
Ph: (509) 822-8662 |
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