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TYLER WALLACE LMSW-CC
NPI 1043036874
Social Worker - Clinical in Portland, ME

Active since November 26, 2024
901 WASHINGTON AVE STE 100, PORTLAND, ME 04103(207) 871-1200(207) 871-1232 Get Directions Write a Review

NPPES record last updated: November 26, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Tyler Wallace Lmsw-cc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TYLER WALLACE LMSW-CC (NPI 1043036874) is an individual clinical provider in Portland, Maine, licensed in Maine (MC24119) and active in the NPI registry since November 2024.

NPPES Registry Identity

NPI1043036874
Entity TypeIndividualMale
Primary Taxonomy1041C0700X
Provider Legal NameTYLER WALLACECredential: LMSW-CC
Location Address901 WASHINGTON AVE STE 100Portland, ME 04103-2842
Mailing Address901 Washington Ave Ste 100Portland, ME 04103-2842 · (207) 871-1200 · Fax (207) 871-1232
Phone(207) 871-1200
Fax(207) 871-1232
Sole ProprietorNo
Enumeration DateNovember 26, 2024
NPPES CertifiedNovember 26, 2024
✔ NPI 1043036874 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License✔ Licensed in ME · MC24119
Definition
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
901 WASHINGTON AVE STE 100, Portland, ME 04103
Open in Google Maps ↗

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

RANI WILSON LCPC-CC
Counselor (Mental Health)
901 WASHINGTON AVE STE 100
PORTLAND, ME 04103
Cumberland County (207) 871-1200
JOSEPH BOUTIN OT
Occupational Therapist
901 WASHINGTON AVE STE 100
PORTLAND, ME 04103
Cumberland County (207) 871-1200
SARA A GLEASON
Social Worker (Clinical)
901 WASHINGTON AVE STE 100
PORTLAND, ME 04103
Cumberland County (207) 871-1200
CHELSEA M WHITE LMSW-CC
Social Worker (Clinical)
901 WASHINGTON AVE STE 100
PORTLAND, ME 04103
Cumberland County (207) 871-1200
ALEXIS A RICE
Social Worker (Clinical)
901 WASHINGTON AVE STE 100
PORTLAND, ME 04103
Cumberland County (207) 871-1200
ANDREW CURTIS PEAKE LMSW-CC
Social Worker (Clinical)
901 WASHINGTON AVE STE 100
PORTLAND, ME 04103
Cumberland County (207) 871-1200
ALLI WINKELMAN LMSW-CC
Social Worker (Clinical)
901 WASHINGTON AVE STE 100
PORTLAND, ME 04103
Cumberland County (120) 787-1120
HANNA R RECKTENWALD LMSW-CC
Social Worker (Clinical)
901 WASHINGTON AVE STE 100
PORTLAND, ME 04103
Cumberland County (207) 871-1200

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Tyler Wallace's NPI number?

The NPI number for Tyler Wallace is 1043036874. It was assigned to this individual provider in the NPPES registry on November 26, 2024.

Where is Tyler Wallace located?

Tyler Wallace practices at 901 Washington Ave Ste 100, Portland, ME 04103. The listed phone number is (207) 871-1200.

What is Tyler Wallace's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

When was this NPI record last updated?

The NPPES record for Tyler Wallace was last updated on November 26, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 20 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.