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MR. REGINAL ARNETT WALLACE LCSW
NPI 1205400066
Social Worker - Clinical in Winter Haven, FL

Active since May 17, 2021PECOS Enrolled
1201 1ST ST S, WINTER HAVEN, FL 33880(863) 293-1121 Get Directions Write a Review

NPPES record last updated: October 4, 2021. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Oct 4, 2021, May 17, 2021 (2 updates tracked since 2021).

About Mr. Reginal Arnett Wallace Lcsw NPPES

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

MR. REGINAL ARNETT WALLACE LCSW (NPI 1205400066) is an individual clinical provider in Winter Haven, Florida, licensed in Florida (SW18482) and active in the NPI registry since May 2021. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1205400066
Entity TypeIndividualMale
Primary Taxonomy1041C0700X
Provider Legal NameMR. REGINAL ARNETT WALLACECredential: LCSW
Location Address1201 1ST ST SWinter Haven, FL 33880-3904
Mailing Address2995 Drew St Fl 3Clearwater, FL 33759-3012
Phone(863) 293-1121
Sole ProprietorNo
Enumeration DateMay 17, 2021
Last NPPES UpdateOctober 4, 20212 updates tracked since enumeration
NPPES CertifiedOctober 4, 2021
✔ NPI 1205400066 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 FL · SW18482
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.
1201 1ST ST S, Winter Haven, FL 33880
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Cigna Healthcare, Cigna HealthCare of Florida, Inc., Florida Blue (BlueCross BlueShield FL) and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mr. Reginal Arnett Wallace Lcsw 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 Reassignments

2

Medicare enrollment records show Reginal Wallace reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Wallace Mental Health & Addiction Counseling LLC
11 mi
Clinical
1810 SADDLEWOOD PL
Bartow, FL 33830
  • Reassigned Medicare billing, Florida enrollment
NPI 1730817149 (863) 529-3725
Behavioral Health Management Services, Inc.
32 mi
Mental Health (Including Community Mental Health Center)
2470 BLOOMINGDALE AVE STE 123
Valrico, FL 33596
  • Reassigned Medicare billing, Florida enrollment
  • 188 clinicians in this Medicare group
NPI 1215403662 (727) 281-9065

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 33880 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$0.00 typical visit price
range $56.00 – $171.84
Typical copayment $0.00 (range $14.00 – $42.96)
Most-billed visit code NA
Established Patient
$70.04 typical visit price
range $17.57 – $139.16
Typical copayment $17.51 (range $4.39 – $34.79)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

MISS ERIN ALETA SWAILS B.S.
Case Manager/Care Coordinator
1201 1ST ST S
WINTER HAVEN, FL 33880
Polk County (863) 293-1121
MS. CLAIRE RICE LCSW
Social Worker (Clinical)
1201 1ST ST S
WINTER HAVEN, FL 33880
Polk County (863) 294-7062
TERESA L EVEN LMHC
Counselor
1201 1ST ST S
WINTER HAVEN, FL 33880
Polk County (863) 294-7062
YONNAR CRUZ MS, LMHC, CAP
Counselor (Mental Health)
1201 1ST ST S
WINTER HAVEN, FL 33880
Polk County (863) 294-7062
MARSIA EMANUEL
Community Health Worker
1201 1ST ST S
WINTER HAVEN, FL 33880
Polk County (863) 297-1702
THERESA D MIXON MS
Case Manager/Care Coordinator
1201 1ST ST S
WINTER HAVEN, FL 33880
Polk County (863) 293-1121
MS. CANISHA SHANARA GILLON PMHNP
Nurse Practitioner (Psychiatric/Mental Health)
1201 1ST ST S
WINTER HAVEN, FL 33880
Polk County (863) 294-7062
GERALD GATLIN LMHC
Counselor (Mental Health)
1201 1ST ST S
WINTER HAVEN, FL 33880
Polk County (863) 797-6680

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 Reginal Wallace's NPI number?

The NPI number for Reginal Wallace is 1205400066. It was assigned to this individual provider in the NPPES registry on May 17, 2021.

Where is Reginal Wallace located?

Reginal Wallace practices at 1201 1st St S, Winter Haven, FL 33880. The listed phone number is (863) 293-1121.

What is Reginal Wallace's specialty?

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

Is Reginal Wallace enrolled in Medicare?

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

Which organizations bill Medicare for Reginal Wallace's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Reginal Wallace reassigns Medicare benefits to 2 organizations: Wallace Mental Health & Addiction Counseling LLC (Bartow, FL) and Behavioral Health Management Services, Inc. (Valrico, FL). Each 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 Reginal Wallace's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Reginal Wallace accept?

Health plans from Cigna HealthCare of Florida, Inc., Cigna Healthcare, Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company) and Oscar Health Maintenance Organization of Florida and 1 other insurer list Reginal 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 Reginal Wallace was last updated on October 4, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years 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.