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SUSAN MOORE-WALLACE
NPI 1790357796
Counselor - Addiction (Substance Use Disorder) in Pottstown, PA

Active since July 11, 2021PECOS EnrolledAccepts Medicare Assignment
11 ROBINSON ST, POTTSTOWN, PA 19464(484) 941-0500 Get Directions Write a Review

NPPES record last updated: July 11, 2021. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Susan Moore-wallace NPPES

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

SUSAN MOORE-WALLACE (NPI 1790357796) is an individual addiction (substance use disorder) provider in Pottstown, Pennsylvania and active in the NPI registry since July 2021. She is enrolled in Medicare PECOS and is a graduate of Other (1997).

NPPES Registry Identity

NPI1790357796
Entity TypeIndividualFemale
Primary Taxonomy101YA0400X
Provider Legal NameSUSAN MOORE-WALLACE
Location Address11 ROBINSON STPottstown, PA 19464-6421
Mailing Address11 Robinson StPottstown, PA 19464-6421 · (484) 941-0500
Phone(484) 941-0500
Sole ProprietorNo
Medical School CMSOtherGraduated 1997
Enumeration DateJuly 11, 2021
NPPES CertifiedJuly 11, 2021
✔ NPI 1790357796 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers
Taxonomy Code101YA0400X
11 ROBINSON ST, Pottstown, PA 19464
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Susan Moore-wallace 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 ID4385111608
PECOS Enrollment IDI20260423002603
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 Susan Moore-wallace reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Creative Health Services Inc
Same address
Mental Health (Including Community Mental Health Center)
11 ROBINSON ST
Pottstown, PA 19464
  • Reassigned Medicare billing, Pennsylvania enrollment
  • 36 clinicians in this Medicare group
NPI 1417110222 (484) 941-0500

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

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.

PRISCILLA BARNES-DAVIS
Counselor
11 ROBINSON ST
POTTSTOWN, PA 19464
Montgomery County (484) 941-0500
ERIN TYNDALL
Counselor
11 ROBINSON ST
POTTSTOWN, PA 19464
Montgomery County (484) 941-0500
ROSANNE R SMITH
Counselor
11 ROBINSON ST
POTTSTOWN, PA 19464
Montgomery County (484) 941-0500
JOANNE BEAUREGARD
Counselor
11 ROBINSON ST
POTTSTOWN, PA 19464
Montgomery County (484) 941-0500
AUTUMN HARRIS
Counselor
11 ROBINSON ST
POTTSTOWN, PA 19464
Montgomery County (484) 941-0500
OLIVIA TOMKO
Counselor (Mental Health)
11 ROBINSON ST
POTTSTOWN, PA 19464
Montgomery County (484) 941-0500
TONIA ANN GREEN
Counselor (Mental Health)
11 ROBINSON ST
POTTSTOWN, PA 19464
Montgomery County (484) 941-0500
JAMES LOGAN POTTS
Counselor (Addiction (Substance Use Disorder))
11 ROBINSON ST
POTTSTOWN, PA 19464
Montgomery County (484) 941-0500

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 Susan Moore-wallace's NPI number?

The NPI number for Susan Moore-wallace is 1790357796. It was assigned to this individual provider in the NPPES registry on July 11, 2021.

Where is Susan Moore-wallace located?

Susan Moore-wallace practices at 11 Robinson St, Pottstown, PA 19464. The listed phone number is (484) 941-0500.

What is Susan Moore-wallace's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Addiction (Substance Use Disorder), with taxonomy code 101YA0400X.

Is Susan Moore-wallace enrolled in Medicare?

Yes. Susan Moore-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.

Which organization bills Medicare for Susan Moore-wallace's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Susan Moore-wallace reassigns Medicare benefits to Creative Health Services Inc (Pottstown, PA). The 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 Susan Moore-wallace's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Susan Moore-wallace was last updated on July 11, 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.