DYLAN WALLACE LCSW, QCSW
NPI 1982269155
Social Worker - Clinical in Plymouth, MA
About Dylan Wallace Lcsw, Qcsw NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DYLAN WALLACE LCSW, QCSW (NPI 1982269155) is an individual clinical provider in Plymouth, Massachusetts, licensed in Massachusetts (LICSW126861) and active in the NPI registry since May 2019. He is enrolled in Medicare PECOS, maintains a secondary practice location in Orem, and is a graduate of Other (2013).
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Secondary Practice Location 1
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
Dylan Wallace Lcsw, Qcsw 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 Dylan Wallace reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Plymouth, MA 02360
- Reassigned Medicare billing, Massachusetts enrollment
- 2 clinicians in this Medicare group
Idaho Falls, ID 83401
- Reassigned Medicare billing, Idaho enrollment
- 12 clinicians in this Medicare group
Orem, UT 84057
- Reassigned Medicare billing, Utah enrollment
- 35 clinicians in this Medicare group
Bothell, WA 98021
- Reassigned Medicare billing, Washington enrollment
- 10 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.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 02360 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
PLYMOUTH, MA 02360
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 Dylan Wallace's NPI number?
The NPI number for Dylan Wallace is 1982269155. It was assigned to this individual provider in the NPPES registry on May 3, 2019. The provider is also known as Dylan Shane Wallace.
Where is Dylan Wallace located?
Dylan Wallace practices at 34 Main Street Ext Ste 104, Plymouth, MA 02360. The listed phone number is (801) 655-5450.
What is Dylan Wallace's specialty?
The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.
Is Dylan Wallace enrolled in Medicare?
Yes. Dylan 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 Dylan Wallace's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Dylan Wallace reassigns Medicare benefits to 4 organizations: Meadowbrook Counseling Of Massachusetts, LLC (Plymouth, MA), Meadowbrook Counseling Of Idaho, LLC (Idaho Falls, ID), Meadowbrook Counseling Of Utah LLC (Orem, UT) and Meadowbrook Counseling Of Washington, LLC (Bothell, WA). 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 Dylan Wallace's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Dylan Wallace accept?
Health plans from Anthem Blue Cross and Blue Shield, BridgeSpan Health Company, Cigna HealthCare of Arizona, Inc, Cigna HealthCare of Florida, Inc. and Cigna Healthcare and 6 other insurers list Dylan 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 Dylan Wallace was last updated on April 2, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.
# Dylan Wallace, LCSW, QCSW · NPI 1982269155
Clinical provider in Plymouth, Massachusetts. Individual provider, active in the CMS NPPES registry since May 3, 2019.
## Identity
- **NPI:** 1982269155 (Entity type: Individual)
- **Enumerated:** May 3, 2019
- **Primary specialty:** Social Worker - Clinical · taxonomy 1041C0700X
- **State license:** LICSW126861 (Massachusetts)
- **Sole proprietor:** No
## Practice location
- **Address:** 34 MAIN STREET EXT STE 104, Plymouth, MA 02360-3375
- **Phone:** (801) 655-5450 · **Fax:** (385) 225-9327
## 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): Meadowbrook Counseling Of Massachusetts, LLC (NPI 1689445488, Plymouth, MA); Meadowbrook Counseling Of Idaho, LLC (NPI 1023889839, Idaho Falls, ID); Meadowbrook Counseling Of Utah LLC (NPI 1225619737, Orem, UT); Meadowbrook Counseling Of Washington, LLC (NPI 1467230284, Bothell, WA) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2013
## Record status
- **NPPES last updated:** April 2, 2026
---
Source: [NPI Profile](https://npiprofile.com/npi/1982269155) · Data from the CMS NPPES public registry.