MRS. TESSA WATERBURY WALLACE LCSW
NPI 1578705950
Social Worker - Clinical in White Salmon, WA

Active since March 31, 2009PECOS EnrolledAccepts Medicare Assignment
65371 HWY 14, WHITE SALMON, WA 98672(509) 493-2133 Get Directions Write a Review

NPPES record last updated: January 13, 2025. Verified against the NPPES registry weekly; last sync: August 30, 2026.

About Mrs. Tessa Waterbury Wallace Lcsw NPPES

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

MRS. TESSA WATERBURY WALLACE LCSW (NPI 1578705950) is an individual clinical provider in White Salmon, Washington, licensed in Washington (LW60171285) and active in the NPI registry since March 2009. She is enrolled in Medicare PECOS, maintains a secondary practice location in The Dalles, and is a graduate of Other (2003).

NPPES Registry Identity

NPI1578705950
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameMRS. TESSA WATERBURY WALLACECredential: LCSW
Location Address65371 HWY 14White Salmon, WA 98672-9867
Mailing Address849 Pacific AveHood River, OR 97031-1956
Sole ProprietorNo
Medical School CMSOtherGraduated 2003
Enumeration DateMarch 31, 2009
Last NPPES UpdateJanuary 13, 2025
NPPES CertifiedJanuary 13, 2025
NPI 1578705950 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
Licenses Licensed in WA · LW60171285 Licensed in OR · L4499
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.
65371 HWY 14, White Salmon, WA 98672

Secondary Practice Location 1

Location 11620 E 12th StThe Dalles, OR 97058 · Phone (541) 296-9151 · Fax (541) 296-9156

Other Identifiers 2

Medicaid2014480WA
Medicaid218112OR

Accepted 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

Mrs. Tessa Waterbury Wallace Lcsw 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 ID1254508187
PECOS Enrollment IDI20180905002963
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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 98672 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 $57.27 – $172.80
Typical copayment $0.00 (range $14.31 – $43.20)
Most-billed visit code NA
Established Patient
$71.29 typical visit price
range $18.56 – $141.11
Typical copayment $17.82 (range $4.64 – $35.27)
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 3

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

Physician Assistant
65371 HWY 14
WHITE SALMON, WA 98672
Physician Assistant
65371 HWY 14
WHITE SALMON, WA 98672
Physician Assistant
65371 HWY 14
WHITE SALMON, WA 98672

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 Tessa Waterbury Wallace's NPI number?

The NPI number for Tessa Waterbury Wallace is 1578705950. It was assigned to this individual provider in the NPPES registry on March 31, 2009.

Where is Tessa Waterbury Wallace located?

Tessa Waterbury Wallace practices at 65371 Hwy 14, White Salmon, WA 98672. The listed phone number is (509) 493-2133.

What is Tessa Waterbury Wallace's specialty?

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

Is Tessa Waterbury Wallace enrolled in Medicare?

Yes. Tessa Waterbury 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 Tessa Waterbury Wallace accept?

Health plans from BridgeSpan Health Company, Moda Health Plan, Inc., PacificSource Health Plans, Premera Blue Cross Blue Shield of Alaska and Providence Health Plan and 1 other insurer list Tessa Waterbury 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 Tessa Waterbury Wallace was last updated on January 13, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.