Lisa M Wallace, MA, LPC in Fort Collins, CO - Medicare Counselor Provider

Lisa M Wallace, MA, LPC is a medicare enrolled "Counselor - Professional" provider in Fort Collins, Colorado. Her current practice location is 4103 E Boardwalk Drive, Suite 202, Fort Collins, Colorado. You can reach out to her office (for appointments etc.) via phone at (970) 817-4049.

Lisa M Wallace is licensed to practice in Colorado (license number 5913) 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 1124002571.

Contact Information

	Lisa M Wallace, MA, LPC
	4103 E Boardwalk Drive, Suite 202, Fort Collins, CO 80525-5930
	(970) 817-4049
	(877) 833-4460

Map and Direction

Healthcare Provider's Profile

Full Name	Lisa M Wallace
Gender	Female
Speciality	Counselor - Professional
Location	4103 E Boardwalk Drive, Fort Collins, Colorado
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1124002571
Provider Enumeration Date: 11/30/2005
Last Update Date: 03/15/2021

Medicare PECOS Information:

PECOS PAC ID: 8426497694
Enrollment ID: I20240419003668

Medical Identifiers

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

Identifier	Type	State	Issuer
1124002571	NPI	-	NPPES
312410	Other	WY	BS OF WY

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
101YM0800X	Counselor - Mental Health	906 (Wyoming)	Secondary
101YP2500X	Counselor - Professional	5913 (Colorado)	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. Lisa M Wallace allows following entities to bill medicare on her behalf.

Entity Name	Wallace Counseling, Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1396028544 PECOS PAC ID: 7517306780 Enrollment ID: O20240419003665

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. Lisa M 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
Lisa M Wallace, MA, LPC Po Box 273338, Fort Collins, CO 80527-3338 Ph: (970) 817-4049	Lisa M Wallace, MA, LPC 4103 E Boardwalk Drive, Suite 202, Fort Collins, CO 80525-5930 Ph: (970) 817-4049

Reviews and Comments

Counselor in Fort Collins, CO

Craig Mcfadden, MA, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 4601 Corbett Dr, Fort Collins, CO 80528 Phone: 970-207-4800 Fax: 970-207-4805
Caroline Catherine Bunn, LPC, MA Counselor Medicare: Not Enrolled in Medicare Practice Location: 4856 Innovation Dr Ste B, Fort Collins, CO 80525 Phone: 970-494-4200
Andrea Strayer, LCSW, CAC II, MSW Counselor Medicare: Accepting Medicare Assignments Practice Location: 4856 Innovation Dr, Fort Collins, CO 80525 Phone: 970-494-4200 Fax: 970-613-4475
Velma G Gallegos, CAC III Counselor Medicare: Not Enrolled in Medicare Practice Location: 525 W Oak St, Fort Collins, CO 80521 Phone: 970-494-4300
Mrs. Kayla Elizabeth Poulson, MA, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 425 W Mulberry St Ste 101, Fort Collins, CO 80521 Phone: 970-530-2887
Monica Rowell, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 4115 Boardwalk Dr, Suite 100, Fort Collins, CO 80525 Phone: 970-493-4580
Stephanie Robyn Saxe, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 1525 Riverside Ave, Fort Collins, CO 80524 Phone: 651-967-2006

Lisa M Wallace, MA, LPC - Medicare Counselor in Fort Collins, CO