Judith Wallace, MAC, LAT in Sheridan, WY - Medicare Counselor Provider

Judith Wallace, MAC, LAT is a medicare enrolled "Counselor - Mental Health" provider in Sheridan, Wyoming. Her current practice location is 1221 W 5th St, Sheridan, Wyoming. You can reach out to her office (for appointments etc.) via phone at (307) 674-4405.

Judith Wallace is licensed to practice in Wyoming (license number 1359) 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 1205373107.

Contact Information

	Judith Wallace, MAC, LAT
	1221 W 5th St, Sheridan, WY 82801-2701
	(307) 674-4405
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Judith Wallace
Gender	Female
Speciality	Counselor - Mental Health
Location	1221 W 5th St, Sheridan, Wyoming
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1205373107
Provider Enumeration Date: 01/30/2017
Last Update Date: 04/06/2023

Medicare PECOS Information:

PECOS PAC ID: 8820539083
Enrollment ID: I20240916002652

Medical Identifiers

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

Identifier	Type	State	Issuer
1205373107	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
101YA0400X	Counselor - Addiction (substance Use Disorder)	352 (Wyoming)	Secondary
171100000X	Acupuncturist	A-030 (Wyoming)	Secondary
101YM0800X	Counselor - Mental Health	1359 (Wyoming)	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. Judith Wallace allows following entities to bill medicare on her behalf.

Entity Name	Volunteers Of America Northern Rockies
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1689249682 PECOS PAC ID: 1355733015 Enrollment ID: O20220110002012

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. Judith 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
Judith Wallace, MAC, LAT 1221 W 5th St, Sheridan, WY 82801-2701 Ph: (307) 674-4405	Judith Wallace, MAC, LAT 1221 W 5th St, Sheridan, WY 82801-2701 Ph: (307) 674-4405

Reviews and Comments

Counselor in Sheridan, WY

Mrs. Sheri Ann Elliott, MS, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 909 Long Dr Ste C, Sheridan, WY 82801 Phone: 307-672-8958 Fax: 307-672-8950
Deiadra Louise Smidt, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 1949 Sugarland Dr, Sheridan, WY 82801 Phone: 307-751-6376 Fax: 307-674-1825
Norman Robertson, Counselor Medicare: Not Enrolled in Medicare Practice Location: 3322 Strahan Pkwy, Sheridan, WY 82801 Phone: 307-672-2044 Fax: 307-674-6867
Dr. Rae Marie Mcreynolds, L. P. C. Counselor Medicare: Not Enrolled in Medicare Practice Location: 23 E Brundage St, Sheridan, WY 82801 Phone: 307-674-9697
Ms. Mary Getrude Caulfield, MSH, LAT, MAC Counselor Medicare: Not Enrolled in Medicare Practice Location: 5 Lane Ln, Sheridan, WY 82801 Phone: 307-675-4100
Lelalelei Nomura, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1981 Double Eagle Dr, Sheridan, WY 82801 Phone: 307-224-7270
Mrs. Andrea Morris, LPCC Counselor Medicare: Not Enrolled in Medicare Practice Location: 172 N Main St Ste 1, Sheridan, WY 82801 Phone: 307-675-8840 Fax: 307-675-6378

Judith Wallace, MAC, LAT - Medicare Counselor in Sheridan, WY