JILL N WALLACE LCSW PLLC
NPI 1356760037
Social Worker in East Northport, NY
About Jill N Wallace Lcsw Pllc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JILL N WALLACE LCSW PLLC (NPI 1356760037) is a healthcare organization registered as a social worker in East Northport, New York and active in the NPI registry since April 2014. The organization lists Jill N Wallace, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Jill N Wallace Lcsw Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Jill N Wallace Lcsw PLLC, which bills Medicare for the services this clinician delivers.
Clinician (1)
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 Jill N Wallace Lcsw PLLC's NPI number?
The NPI number for Jill N Wallace Lcsw PLLC is 1356760037. It was assigned to this organization in the NPPES registry on April 10, 2014.
Where is Jill N Wallace Lcsw PLLC located?
Jill N Wallace Lcsw PLLC is located at 15 Heath Ln, East Northport, NY 11731. The listed phone number is (516) 459-0312.
What is Jill N Wallace Lcsw PLLC's specialty?
The primary specialty registered for this NPI is Social Worker with taxonomy code 104100000X.
Is Jill N Wallace Lcsw PLLC enrolled in Medicare?
Yes. Jill N Wallace Lcsw PLLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Jill N Wallace Lcsw PLLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Clinical Social Worker) reassigns their Medicare billing to Jill N Wallace Lcsw PLLC. A 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 the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Jill N Wallace Lcsw PLLC was last updated on July 19, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.
# Jill N Wallace Lcsw Pllc · NPI 1356760037
Social Worker organization in East Northport, New York. Organization record, active in the CMS NPPES registry since April 10, 2014.
## Identity
- **NPI:** 1356760037 (Entity type: Organization)
- **Enumerated:** April 10, 2014
- **Primary specialty:** Social Worker · taxonomy 104100000X
- **Organization subpart:** No
- **Authorized official:** Jill Wallace, OWNER
## Practice location
- **Address:** 15 HEATH LN, East Northport, NY 11731-1912
- **Phone:** (516) 459-0312
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Clinical Social Worker) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** July 19, 2024
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Source: [NPI Profile](https://npiprofile.com/npi/1356760037) · Data from the CMS NPPES public registry.