Mrs Elaine Marie Wallace, LCPC in Glen Burnie, MD

Mrs Elaine Marie Wallace, LCPC is a medicare enrolled "Counselor - Professional" provider in Glen Burnie, Maryland. Her current practice location is 204 Somerset Bay Dr Apt 201, Glen Burnie, Maryland. You can reach out to her office (for appointments etc.) via phone at (410) 903-8473.

Mrs Elaine Marie Wallace is licensed to practice in Maryland (license number LC13561) 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 1962084574.

Contact Information

	Mrs Elaine Marie Wallace, LCPC
	204 Somerset Bay Dr Apt 201, Glen Burnie, MD 21061-6476
	(410) 903-8473
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Mrs Elaine Marie Wallace
Gender	Female
Speciality	Counselor - Professional
Location	204 Somerset Bay Dr Apt 201, Glen Burnie, Maryland
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1962084574
Provider Enumeration Date: 04/22/2021
Last Update Date: 08/29/2023

Medicare PECOS Information:

PECOS PAC ID: 0345773404
Enrollment ID: I20241028001998

Medical Identifiers

Medical identifiers for Mrs Elaine Marie Wallace such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1962084574	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
101YP2500X	Counselor - Professional	LC13561 (Maryland)	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. Mrs Elaine Marie Wallace allows following entities to bill medicare on her behalf.

Entity Name	Safe Harbor Behavioral Care Chesapeake Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1295246718 PECOS PAC ID: 0042578171 Enrollment ID: O20171219003042

Entity Name	Sondermind Provider Network Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1760854442 PECOS PAC ID: 9537572490 Enrollment ID: O20210908001372

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. Mrs Elaine Marie 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
Mrs Elaine Marie Wallace, LCPC 204 Somerset Bay Dr Apt 201, Glen Burnie, MD 21061-6476 Ph: (410) 903-8473	Mrs Elaine Marie Wallace, LCPC 204 Somerset Bay Dr Apt 201, Glen Burnie, MD 21061-6476 Ph: (410) 903-8473

Reviews and Comments

Counselor in Glen Burnie, MD

Ms. Leslie A Stanbury, MS Counselor Medicare: Not Enrolled in Medicare Practice Location: 122 Langley Road North, Suite B, Glen Burnie, MD 21060 Phone: 410-222-0100 Fax: 410-222-0116
Sharon Clements, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1410 Crain Hwy N, Glen Burnie, MD 21061 Phone: 443-768-7235
Ms. Traci A. Olivier, CSC-AD Counselor Medicare: Not Enrolled in Medicare Practice Location: 122 Langley Road North, Suite B, Glen Burnie, MD 21060 Phone: 410-222-0100 Fax: 410-222-0116
Lissette Wright, Counselor Medicare: Not Enrolled in Medicare Practice Location: 898 Airport Park Rd Ste 101, Glen Burnie, MD 21061 Phone: 443-599-9460
Allison Tate Pastine, LCPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 7401 Ritchie Hwy, Glen Burnie, MD 21061 Phone: 443-250-6653 Fax: 410-740-8068
Tiffany Nicole Huff, ADT Counselor Medicare: Not Enrolled in Medicare Practice Location: 1401 Madison Park Dr, Glen Burnie, MD 21061 Phone: 410-999-0891
Mary Hanauska Ferreira, LCPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 30 Greenway St Nw, Suite 5, Glen Burnie, MD 21061 Phone: 410-760-9079 Fax: 410-760-1121

Mrs Elaine Marie Wallace, LCPC - Medicare Counselor in Glen Burnie, MD