Mr Reginal Arnett Wallace, LCSW in Winter Haven, FL

Mr Reginal Arnett Wallace, LCSW is a medicare enrolled "Social Worker - Clinical" provider in Winter Haven, Florida. His current practice location is 1201 1st St S, Winter Haven, Florida. You can reach out to his office (for appointments etc.) via phone at (863) 293-1121.

Mr Reginal Arnett Wallace is licensed to practice in Florida (license number SW18482) 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 1205400066.

Contact Information

	Mr Reginal Arnett Wallace, LCSW
	1201 1st St S, Winter Haven, FL 33880-3904
	(863) 293-1121
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Mr Reginal Arnett Wallace
Gender	Male
Speciality	Social Worker - Clinical
Location	1201 1st St S, Winter Haven, Florida
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1205400066
Provider Enumeration Date: 05/17/2021
Last Update Date: 10/04/2021

Medicare PECOS Information:

PECOS PAC ID: 1355740911
Enrollment ID: I20210602000232

Medical Identifiers

Medical identifiers for Mr Reginal Arnett Wallace such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1205400066	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
1041C0700X	Social Worker - Clinical	SW18482 (Florida)	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. Mr Reginal Arnett Wallace allows following entities to bill medicare on his behalf.

Entity Name	Behavioral Health Management Services, Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1417052713 PECOS PAC ID: 1456262450 Enrollment ID: O20040115000480

Entity Name	Wallace Mental Health & Addiction Counseling Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1730817149 PECOS PAC ID: 5193195881 Enrollment ID: O20221221000003

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 Reginal Arnett 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 Reginal Arnett Wallace, LCSW 2995 Drew St Fl 3, Clearwater, FL 33759-3012 Ph: () -	Mr Reginal Arnett Wallace, LCSW 1201 1st St S, Winter Haven, FL 33880-3904 Ph: (863) 293-1121

Reviews and Comments

Social Worker in Winter Haven, FL

Ms. Claire Rice, LCSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 1201 1st St S, Winter Haven, FL 33880 Phone: 863-294-7062 Fax: 863-294-7064
Suzette Woten, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1201 1st Street South, Winter Haven, FL 33880 Phone: 863-297-1702 Fax: 863-291-6084
Michele Faucher, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1201 First St South, Winter Haven, FL 33880 Phone: 863-297-1702 Fax: 863-291-6084
Catherine Jane Igo, LCSW, CEAP Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 630 Pope Ave Nw, Winter Haven, FL 33881 Phone: 863-370-7281 Fax: 863-292-2201
Mr. Kevin Sanders, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1201 First Street South, Winter Haven, FL 33880 Phone: 863-297-1702 Fax: 863-291-6084
Sharon Mcdaniel, Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 207 Edelweiss Dr, Winter Haven, FL 33881 Phone: 908-907-3002
Cynthia Canales, LCSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 1 Buckeye Cir Ne, Winter Haven, FL 33881 Phone: 863-224-7174

Mr Reginal Arnett Wallace, LCSW - Medicare Clinical Social Worker in Winter Haven, FL