GARY WALLER LCSW
NPI 1609546399
Social Worker - Clinical in Picayune, MS

Q: What is Gary Waller's NPI number?

The NPI number for Gary Waller is 1609546399. It was assigned to this individual provider in the NPPES registry on September 15, 2021.

Q: What is Gary Waller's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Gary Waller was last updated on June 22, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.

Active since September 15, 2021PECOS Enrolled

417 W CANAL ST, PICAYUNE, MS 39466(601) 749-9477(769) 242-0030 Get Directions Write a Review

NPPES record last updated: June 22, 2026. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Mar 12, 2026, Sep 15, 2021 (2 updates tracked since 2021).

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About Gary Waller Lcsw NPPES

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

GARY WALLER LCSW (NPI 1609546399) is an individual clinical provider in Picayune, Mississippi, licensed in Mississippi (C11878) and active in the NPI registry since September 2021. He is enrolled in Medicare PECOS and is a graduate of Other (2020).

NPPES Registry Identity

NPI1609546399

Entity TypeIndividualMale

Primary Taxonomy1041C0700X

Provider Legal NameGARY WALLERCredential: LCSW

Location Address417 W CANAL STPicayune, MS 39466-3951

Mailing Address417 W Canal StPicayune, MS 39466-3951 · (601) 749-9477 · Fax (601) 749-0605

Phone(601) 749-9477

Fax(769) 242-0030

Sole ProprietorYes

Medical School CMSOtherGraduated 2020

Enumeration DateSeptember 15, 2021

Last NPPES UpdateJune 22, 20262 updates tracked since enumeration

NPPES CertifiedJune 22, 2026

✔ NPI 1609546399 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 MS · C11878

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.

417 W CANAL ST, Picayune, MS 39466

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Oscar Health Plan, Inc., 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)

Gary Waller Lcsw is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID5193293280

PECOS Enrollment IDI20260506004333

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 Gary Waller reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Gary Waller Lcsw LLC

2.5 mi

Clinical

1839 COOPER RD STE D
Picayune, MS 39466

Reassigned Medicare billing, Mississippi enrollment

NPI 1447108550 (601) 749-9477

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 39466 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 $51.65 – $159.18

Typical copayment $0.00 (range $12.91 – $39.79)

Most-billed visit code NA

Established Patient

$64.96 typical visit price

range $16.15 – $129.61

Typical copayment $16.24 (range $4.03 – $32.40)

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 7

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

NEW LEAF MENTAL HEALTH & WELLNESS, PLLC

Clinic/Center (Multi-Specialty)