Carolyn Wallace, LICSW is a medicare enrolled "Social Worker - Clinical" provider in S Deerfield, Massachusetts. She went to Temple University School Of Medicine and graduated in 1994 and has 31 years of diverse experience with area of expertise as Clinical Social Worker. Her current practice location is
66 N Main St, S Deerfield, Massachusetts. You can reach out to her office (for appointments etc.) via phone at
(413) 320-6950.
Carolyn Wallace is licensed to practice in Massachusetts (license number 119611) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1962595835.
Healthcare Provider's Profile
Full Name | Carolyn Wallace |
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Gender | Female |
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Speciality | Clinical Social Worker |
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Experience | 31 Years |
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Location | 66 N Main St, S Deerfield, Massachusetts |
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Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Medical Education and Training:
- Carolyn Wallace attended and graduated from Temple University School Of Medicine in 1994
NPI Data:
- NPI Number: 1962595835
- Provider Enumeration Date: 10/02/2006
- Last Update Date: 12/20/2021
Medicare PECOS Information:
- PECOS PAC ID: 7618023151
- Enrollment ID: I20090924000166
Medical Identifiers
Medical identifiers for Carolyn Wallace such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1962595835 | NPI | - | NPPES |
11011717B | Medicaid | MA | |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
1041C0700X | Social Worker - Clinical | 119611 (Massachusetts) | Primary |
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. Carolyn 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 |
Carolyn Wallace, LICSW 66 N Main St, S Deerfield, MA 01373-0916 Ph: (413) 320-6950 | Carolyn Wallace, LICSW 66 N Main St, S Deerfield, MA 01373-0137 Ph: (413) 320-6950 |
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