Fallon Victoria Wall, in Charlotte, NC - Medicare Counselor Provider

Fallon Victoria Wall, is a medicare enrolled "Counselor - Mental Health" provider in Charlotte, North Carolina. Her current practice location is 610 E 7th St, Charlotte, North Carolina. You can reach out to her office (for appointments etc.) via phone at (980) 474-1716.

Fallon Victoria Wall is licensed to practice in North Carolina (license number A12803) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1033636386.

Contact Information

	Fallon Victoria Wall,
	610 E 7th St, Charlotte, NC 28202-2923
	(980) 474-1716
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Fallon Victoria Wall
Gender	Female
Speciality	Counselor - Mental Health
Location	610 E 7th St, Charlotte, North Carolina
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1033636386
Provider Enumeration Date: 08/28/2017
Last Update Date: 08/28/2017

Medicare PECOS Information:

PECOS PAC ID: 2567811151
Enrollment ID: I20231207002767

Medical Identifiers

Medical identifiers for Fallon Victoria Wall such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1033636386	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
101YM0800X	Counselor - Mental Health	A12803 (North Carolina)	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. Fallon Victoria Wall allows following entities to bill medicare on her behalf.

Entity Name	Thriveworks Clinical - North Carolina Pc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1003303082 PECOS PAC ID: 8527471200 Enrollment ID: O20210120000669

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. Fallon Victoria Wall 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
Fallon Victoria Wall, 707 Regency Dr, Charlotte, NC 28211-5418 Ph: (704) 591-2019	Fallon Victoria Wall, 610 E 7th St, Charlotte, NC 28202-2923 Ph: (980) 474-1716

Reviews and Comments

Counselor in Charlotte, NC

Dr. Jeff Randall Mishoe, D.MIN. Counselor Medicare: Not Enrolled in Medicare Practice Location: 310 East Blvd, C-8, Charlotte, NC 28203 Phone: 704-344-1100 Fax: 704-344-1100
Allegra Shonta Cooper, LCMHC Counselor Medicare: Medicare Enrolled Practice Location: 6324 Fairview Rd Ste 460, Charlotte, NC 28210 Phone: 980-302-8611 Fax: 980-302-8624
Meredith Garofalo, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 2339 Chesterfield Ave, Charlotte, NC 28205 Phone: 773-263-6765
Reggie Moses, ST. Counselor Medicare: Not Enrolled in Medicare Practice Location: 900 East Blvd, Charlotte, NC 28203 Phone: 704-332-0081 Fax: 704-332-0085
Dr. Terri Lynn Tilford, EDD Counselor Medicare: Not Enrolled in Medicare Practice Location: 10130 Mallard Creek Rd Ste 300, Charlotte, NC 28262 Phone: 980-689-4127
Emily Reiner, Counselor Medicare: Not Enrolled in Medicare Practice Location: 2511 Yadkin Ave, Charlotte, NC 28205 Phone: 470-289-6301
Lindsey Yvette Donatien, LCMHC Counselor Medicare: Not Enrolled in Medicare Practice Location: 5200 Park Rd Ste 218b, Charlotte, NC 28209 Phone: 866-700-1606 Fax: 866-338-5921

Fallon Victoria Wall, - Medicare Counselor in Charlotte, NC