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LISA M WALLACE MA, LPC
NPI 1124002571
Counselor - Professional in Fort Collins, CO

Active since November 30, 2005PECOS Enrolled
4103 E BOARDWALK DRIVE, SUITE 202, FORT COLLINS, CO 80525(970) 817-4049(877) 833-4460 Get Directions Write a Review

NPPES record last updated: December 1, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Dec 1, 2025, Mar 15, 2021 (2 updates tracked since 2021).

About Lisa M Wallace Ma, Lpc NPPES

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

LISA M WALLACE MA, LPC (NPI 1124002571) is an individual professional provider in Fort Collins, Colorado, licensed in Colorado (5913) and active in the NPI registry since November 2005. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1124002571
Entity TypeIndividualFemale
Primary Taxonomy101YP2500X
Provider Legal NameLISA M WALLACECredential: MA, LPC
Location Address4103 E BOARDWALK DRIVE, SUITE 202Fort Collins, CO 80525-5930
Mailing AddressPo Box 273338Fort Collins, CO 80527-3338 · (970) 817-4049 · Fax (877) 833-4460
Phone(970) 817-4049
Fax(877) 833-4460
Sole ProprietorNo
Enumeration DateNovember 30, 2005
Last NPPES UpdateDecember 1, 20252 updates tracked since enumeration
NPPES CertifiedDecember 1, 2025
✔ NPI 1124002571 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
Licenses✔ Licensed in CO · 5913✔ Licensed in WY · 906
4103 E BOARDWALK DRIVE, Fort Collins, CO 80525
Open in Google Maps ↗

Other Identifiers 1

Other312410WY · Bs Of Wy

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross Blue Shield of Wyoming, Oscar Insurance Company, UnitedHealthcare.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Lisa M Wallace Ma, Lpc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Lisa Wallace reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Wallace Counseling, LLC
Same address
Professional
4103 BOARDWALK DR UNIT 202
Fort Collins, CO 80525
  • Reassigned Medicare billing, Colorado enrollment
NPI 1396028544 (970) 817-4049

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 Lisa Wallace's NPI number?

The NPI number for Lisa Wallace is 1124002571. It was assigned to this individual provider in the NPPES registry on November 30, 2005.

Where is Lisa Wallace located?

Lisa Wallace practices at 4103 E Boardwalk Drive Suite 202, Fort Collins, CO 80525. The listed phone number is (970) 817-4049.

What is Lisa Wallace's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

Is Lisa Wallace enrolled in Medicare?

Yes. Lisa Wallace is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Lisa Wallace's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Lisa Wallace reassigns Medicare benefits to Wallace Counseling, LLC (Fort Collins, CO). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Lisa Wallace's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Lisa Wallace accept?

Health plans from Blue Cross Blue Shield of Wyoming, Oscar Insurance Company and UnitedHealthcare list Lisa Wallace as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Lisa Wallace was last updated on December 1, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.