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BRADLEY S WALLACE LMFT
NPI 1215706528
Marriage & Family Therapist in Bristol, TN

Active since December 28, 2023PECOS EnrolledAccepts Medicare Assignment
1145 VOLUNTEER PKWY, BRISTOL, TN 37620(423) 989-4500(423) 989-4582 Get Directions Write a Review

NPPES record last updated: March 4, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Bradley S Wallace Lmft NPPES

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

BRADLEY S WALLACE LMFT (NPI 1215706528) is an individual marriage & family therapist in Bristol, Tennessee, licensed in Tennessee (1777) and active in the NPI registry since December 2023. He is enrolled in Medicare PECOS and is a graduate of Other (1994).

NPPES Registry Identity

NPI1215706528
Entity TypeIndividualMale
Primary Taxonomy106H00000X
Provider Legal NameBRADLEY S WALLACECredential: LMFT
Location Address1145 VOLUNTEER PKWYBristol, TN 37620-4652
Mailing Address1167 Spratlin Park DrGray, TN 37615-6205 · (423) 467-3600 · Fax (423) 467-3644
Phone(423) 989-4500
Fax(423) 989-4582
Sole ProprietorNo
Medical School CMSOtherGraduated 1994
Enumeration DateDecember 28, 2023
Last NPPES UpdateMarch 4, 2025
NPPES CertifiedMarch 4, 2025
✔ NPI 1215706528 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyMarriage & Family TherapistBehavioral Health & Social Service Providers
Taxonomy Code106H00000X
License✔ Licensed in TN · 1777
Definition
A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups.
1145 VOLUNTEER PKWY, Bristol, TN 37620
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BlueCross BlueShield of Tennessee, Oscar Insurance Company.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Bradley S Wallace Lmft is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID5799136222
PECOS Enrollment IDI20240109004642
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.

Other Providers at the Same Location NPPES 11

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

LADONNA L GROVES LPC, MHSP
Counselor (Professional)
1145 VOLUNTEER PKWY
BRISTOL, TN 37620
Sullivan County (423) 989-4500
CORTNEE R LEE LPC, MHSP
Counselor (Professional)
1145 VOLUNTEER PKWY
BRISTOL, TN 37620
Sullivan County (423) 989-4500
HARLOW M RHUDY LCSW
Social Worker (Clinical)
1145 VOLUNTEER PKWY
BRISTOL, TN 37620
Sullivan County (423) 989-4500
MADELAINE G SCHUMACHER LCSW
Social Worker (Clinical)
1145 VOLUNTEER PKWY
BRISTOL, TN 37620
Sullivan County (423) 989-4500
DOROTHY SUE CHAPMAN FNP-BC
Nurse Practitioner (Family)
1145 VOLUNTEER PKWY
BRISTOL, TN 37620
Sullivan County (423) 989-4500
MRS. FELECIA GAIL ABDELFATTAH APRN BC
Nurse Practitioner (Family)
1145 VOLUNTEER PKWY
BRISTOL, TN 37620
Sullivan County (423) 989-4500
MICHELLE MARIE MONCIER
Durable Medical Equipment & Medical Supplies
1145 VOLUNTEER PKWY, SUTIE 5
BRISTOL, TN 37620
Sullivan County (423) 764-2713
VICTORIA C TAYLOR LCSW
Social Worker (Clinical)
1145 VOLUNTEER PKWY
BRISTOL, TN 37620
Sullivan County (423) 989-4500

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 Bradley Wallace's NPI number?

The NPI number for Bradley Wallace is 1215706528. It was assigned to this individual provider in the NPPES registry on December 28, 2023.

Where is Bradley Wallace located?

Bradley Wallace practices at 1145 Volunteer Pkwy, Bristol, TN 37620. The listed phone number is (423) 989-4500.

What is Bradley Wallace's specialty?

The primary specialty registered for this NPI is Marriage & Family Therapist with taxonomy code 106H00000X.

Is Bradley Wallace enrolled in Medicare?

Yes. Bradley Wallace is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Bradley Wallace accept?

Health plans from BlueCross BlueShield of Tennessee and Oscar Insurance Company list Bradley 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 Bradley Wallace was last updated on March 4, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 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.