MRS. ELAINE MARIE WALLACE LCPC
NPI 1962084574
Counselor - Professional in Glen Burnie, MD
About Mrs. Elaine Marie Wallace Lcpc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MRS. ELAINE MARIE WALLACE LCPC (NPI 1962084574) is an individual professional provider in Glen Burnie, Maryland, licensed in Maryland (LC13561) and active in the NPI registry since April 2021. She is enrolled in Medicare PECOS and is a graduate of Other (2020).
NPPES Registry Identity
Specialties & Licenses
Accepted Insurance
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
Mrs. Elaine Marie Wallace Lcpc 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.
Medicare Billing Reassignments
4Medicare enrollment records show Elaine Wallace reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Annapolis, MD 21401
- Reassigned Medicare billing, Maryland enrollment
- 12 clinicians in this Medicare group
Durham, NC 27701
- Reassigned Medicare billing, Maryland enrollment
- 71 clinicians in this Medicare group
Wichita, KS 67202
- Reassigned Medicare billing, Pennsylvania enrollment
- Medicare enrollment name: Sondermind PA
- 70 clinicians in this Medicare group
Denver, CO 80202
- Reassigned Medicare billing, Maryland and South Carolina enrollments
- 179 clinicians in this Medicare group
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
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
GLEN BURNIE, MD 21061
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 Elaine Wallace's NPI number?
The NPI number for Elaine Wallace is 1962084574. It was assigned to this individual provider in the NPPES registry on April 22, 2021.
Where is Elaine Wallace located?
Elaine Wallace practices at 204 Somerset Bay Dr Apt 201, Glen Burnie, MD 21061. The listed phone number is (410) 903-8473.
What is Elaine Wallace's specialty?
The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.
Is Elaine Wallace enrolled in Medicare?
Yes. Elaine 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 organizations bill Medicare for Elaine Wallace's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Elaine Wallace reassigns Medicare benefits to 4 organizations: Safe Harbor Behavioral Care Chesapeake LLC (Annapolis, MD), Mental Health Specialty Group PA (Durham, NC), Sondermind, P.A. (Wichita, KS) and Sondermind Provider Network LLC (Denver, CO). Each 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 Elaine Wallace's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Elaine Wallace accept?
Health plans from Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Superior HealthPlan and Ambetter of Oklahoma and 2 other insurers list Elaine 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 Elaine Wallace was last updated on August 29, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.
# Mrs. Elaine Marie Wallace, LCPC · NPI 1962084574
Professional provider in Glen Burnie, Maryland. Individual provider, active in the CMS NPPES registry since April 22, 2021.
## Identity
- **NPI:** 1962084574 (Entity type: Individual)
- **Enumerated:** April 22, 2021
- **Primary specialty:** Counselor - Professional · taxonomy 101YP2500X
- **State license:** LC13561 (Maryland)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 204 SOMERSET BAY DR APT 201, Glen Burnie, MD 21061-6476
- **Phone:** (410) 903-8473
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment
- **Bills Medicare through:** 4 organizations under Medicare reassignment (form CMS-855R): Safe Harbor Behavioral Care Chesapeake LLC (NPI 1295246718, Annapolis, MD); Mental Health Specialty Group PA (NPI 1801472634, Durham, NC); Sondermind, P.A. (NPI 1710647581, Wichita, KS); Sondermind Provider Network LLC (NPI 1760854442, Denver, CO) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2020
## Record status
- **NPPES last updated:** August 29, 2023
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Source: [NPI Profile](https://npiprofile.com/npi/1962084574) · Data from the CMS NPPES public registry.