Ms Kimberly Wallace, LPC in Marietta, GA - Medicare Counselor Provider

Ms Kimberly Wallace, LPC is a medicare enrolled "Counselor - Professional" provider in Marietta, Georgia. Her current practice location is 2852 Johnson Ferry Rd Ste 100, Marietta, Georgia. You can reach out to her office (for appointments etc.) via phone at (404) 906-9831.

Ms Kimberly Wallace is licensed to practice in Georgia (license number LPC008384) 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 1083091987.

Contact Information

	Ms Kimberly Wallace, LPC
	2852 Johnson Ferry Rd Ste 100, Marietta, GA 30062-5686
	(404) 906-9831
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Ms Kimberly Wallace
Gender	Female
Speciality	Counselor - Professional
Location	2852 Johnson Ferry Rd Ste 100, Marietta, Georgia
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1083091987
Provider Enumeration Date: 04/29/2015
Last Update Date: 11/24/2023

Medicare PECOS Information:

PECOS PAC ID: 7214371475
Enrollment ID: I20240215004330

Medical Identifiers

Medical identifiers for Ms Kimberly Wallace such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1083091987	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
101YP2500X	Counselor - Professional	LPC008384 (Georgia)	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. Ms Kimberly Wallace allows following entities to bill medicare on her behalf.

Entity Name	Kimberly Wallace Lpc Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1659987238 PECOS PAC ID: 6406290667 Enrollment ID: O20240215004285

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. Ms Kimberly 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
Ms Kimberly Wallace, LPC 2852 Johnson Ferry Rd Ste 100, Marietta, GA 30062-5686 Ph: (404) 906-9831	Ms Kimberly Wallace, LPC 2852 Johnson Ferry Rd Ste 100, Marietta, GA 30062-5686 Ph: (404) 906-9831

Reviews and Comments

Counselor in Marietta, GA

Daniella Atwell, MA Counselor Medicare: Not Enrolled in Medicare Practice Location: 2520 Windy Hill Rd Se Ste 203, Marietta, GA 30067 Phone: 770-953-6401
Nia Jowan Grant, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 2172 Asquith Ave Sw, Marietta, GA 30008 Phone: 678-488-7539 Fax: 770-439-0524
Teresa Cress, M.A., LPC, LMFT, NCC Counselor Medicare: Not Enrolled in Medicare Practice Location: 2655 Dallas Hwy Sw, Suite 310, Marietta, GA 30064 Phone: 404-551-5265
Vanessa Desir, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1355 Terrell Mill Rd Se, Bldg. 1460 Suite 205, Marietta, GA 30067 Phone: 404-439-9981
Tania Van Rochelle-catoe, MS LPC NCC Counselor Medicare: Medicare Enrolled Practice Location: 376 Powder Springs St Ste 240a, Marietta, GA 30064 Phone: 678-444-4505
Maria Edna Garcia, Counselor Medicare: Not Enrolled in Medicare Practice Location: 4343 Shallowford Rd Ste C2, Marietta, GA 30062 Phone: 404-579-2833 Fax: 770-993-9800
Frieda Wright, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1650 County Services Pkwy Sw, Marietta, GA 30008 Phone: 770-514-2422 Fax: 770-422-7545

Ms Kimberly Wallace, LPC - Medicare Counselor in Marietta, GA