Jerryd Wallace, LPC in Van Alstyne, TX - Medicare Counselor Provider

Jerryd Wallace, LPC is a medicare enrolled "Counselor - Professional" provider in Van Alstyne, Texas. His current practice location is 162 N. Dallas Ave, Van Alstyne, Texas. You can reach out to his office (for appointments etc.) via phone at (469) 667-3515.

Jerryd Wallace is licensed to practice in Texas (license number 77418) 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 1821573387.

Contact Information

	Jerryd Wallace, LPC
	162 N. Dallas Ave, Van Alstyne, TX 75495-7549
	(469) 667-3515
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Jerryd Wallace
Gender	Male
Speciality	Counselor - Professional
Location	162 N. Dallas Ave, Van Alstyne, Texas
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1821573387
Provider Enumeration Date: 10/01/2018
Last Update Date: 10/01/2018

Medicare PECOS Information:

PECOS PAC ID: 9537517396
Enrollment ID: I20231205000721

Medical Identifiers

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

Identifier	Type	State	Issuer
1821573387	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
101YP2500X	Counselor - Professional	77418 (Texas)	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. Jerryd Wallace allows following entities to bill medicare on his behalf.

Entity Name	Texoma Community Center
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1851309462 PECOS PAC ID: 6608830104 Enrollment ID: O20041115000959

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. Jerryd 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
Jerryd Wallace, LPC Po Box 2020, Van Alstyne, TX 75495-2020 Ph: (469) 667-3515	Jerryd Wallace, LPC 162 N. Dallas Ave, Van Alstyne, TX 75495-7549 Ph: (469) 667-3515

Reviews and Comments

Counselor in Van Alstyne, TX

Lisa O'connor, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 902 Edwards Rd, Van Alstyne, TX 75495 Phone: 214-394-4517
Jill Renae Heilman, Counselor Medicare: Not Enrolled in Medicare Practice Location: 15048 Us Highway 75 Ste 4, Van Alstyne, TX 75495 Phone: 903-815-1671
Craig Turczynski, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1233 Eagle Point Rd, Van Alstyne, TX 75495 Phone: 314-888-5233 Fax: 203-590-8644
Mr. Lester Isaac Bloomenstiel, M.S., L.P.C. Counselor Medicare: Not Enrolled in Medicare Practice Location: 7454 Fm 121, Van Alstyne, TX 75495 Phone: 903-482-5128 Fax: 903-482-5128
Bonnie Donaldson, LCDC, CFLE Counselor Medicare: Not Enrolled in Medicare Practice Location: 156 Daniel Dr, Van Alstyne, TX 75495 Phone: 214-585-1414
Leigh Wood, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 746 S. Waco, Van Alstyne, TX 75495 Phone: 903-267-0048

Jerryd Wallace, LPC - Medicare Counselor in Van Alstyne, TX