Amaya O Wallace, LCSW-A, LCAS-A is a
Social Worker based in Raleigh, North Carolina. Amaya O Wallace is licensed to practice in North Carolina (license number ) and her current practice location is
6118 Saint Giles St Ste 120, Raleigh, North Carolina. She can be reached at her office (for appointments etc.) via phone at
(984) 278-8449.
NPI number for Amaya O Wallace is 1588492664 and her current mailing address is 6118 Saint Giles St Ste 120, Raleigh, North Carolina. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1588492664.
Healthcare Provider's Profile
| Full Name | Amaya O Wallace |
|---|
| Gender | Female |
|---|
| Speciality | Social Worker |
|---|
| Location | 6118 Saint Giles St Ste 120, Raleigh, North Carolina |
|---|
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
|---|
NPI Data:
- NPI Number: 1588492664
- Provider Enumeration Date: 07/22/2024
- Last Update Date: 07/22/2024
Medical Identifiers
Medical identifiers for Amaya O Wallace such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1588492664 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (North Carolina) | Secondary |
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Secondary |
| 374J00000X | Doula | (* (Not Available)) | Secondary |
| 104100000X | Social Worker | (North Carolina) | 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. Amaya O Wallace is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Amaya O Wallace, LCSW-A, LCAS-A
6118 Saint Giles St Ste 120,
Raleigh, NC 27612-7045
Ph: () - | Amaya O Wallace, LCSW-A, LCAS-A
6118 Saint Giles St Ste 120,
Raleigh, NC 27612-7045
Ph: (984) 278-8449 |
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