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JERRYD WALLACE LPC
NPI 1821573387
Counselor - Professional in Van Alstyne, TX

Active since October 01, 2018PECOS Enrolled
162 N. DALLAS AVE, VAN ALSTYNE, TX 75495(469) 667-3515 Get Directions Write a Review

NPPES record last updated: October 1, 2018. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Jerryd Wallace Lpc NPPES

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

JERRYD WALLACE LPC (NPI 1821573387) is an individual professional provider in Van Alstyne, Texas, licensed in Texas (77418) and active in the NPI registry since October 2018. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1821573387
Entity TypeIndividualMale
Primary Taxonomy101YP2500X
Provider Legal NameJERRYD WALLACECredential: LPC
Location Address162 N. DALLAS AVEVan Alstyne, TX 75495-7549
Mailing AddressPo Box 2020Van Alstyne, TX 75495-2020 · (469) 667-3515
Phone(469) 667-3515
Sole ProprietorNo
Enumeration DateOctober 1, 2018
✔ NPI 1821573387 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
License✔ Licensed in TX · 77418
162 N. DALLAS AVE, Van Alstyne, TX 75495
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Texas.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jerryd Wallace Lpc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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

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

HOPE FOR HOME COUNSELING
Clinic/Center (Mental Health (Including Community Mental Health Center))
162 N. DALLAS AVE
VAN ALSTYNE, TX 75495
Grayson County (469) 667-3515

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 Jerryd Wallace's NPI number?

The NPI number for Jerryd Wallace is 1821573387. It was assigned to this individual provider in the NPPES registry on October 1, 2018.

Where is Jerryd Wallace located?

Jerryd Wallace practices at 162 N. Dallas Ave, Van Alstyne, TX 75495. The listed phone number is (469) 667-3515.

What is Jerryd Wallace's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

Is Jerryd Wallace enrolled in Medicare?

Yes. Jerryd Wallace is registered in the Medicare PECOS enrollment system.

What insurance does Jerryd Wallace accept?

Health plans from Blue Cross and Blue Shield of Texas list Jerryd 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 Jerryd Wallace was last updated on October 1, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.