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DYLAN WALLACE LCSW, QCSW
NPI 1982269155
Social Worker - Clinical in Plymouth, MA

Active since May 03, 2019PECOS EnrolledAccepts Medicare Assignment
34 MAIN STREET EXT STE 104, PLYMOUTH, MA 02360(801) 655-5450(385) 225-9327 Get Directions Write a Review

NPPES record last updated: April 2, 2026. Verified against the NPPES registry weekly; last sync: August 23, 2026.

Record update history: Apr 2, 2026, Dec 30, 2024, Jun 5, 2024 and 1 more (4 updates tracked since 2019).

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

NPI1982269155
Entity TypeIndividualMale
Primary Taxonomy1041C0700X
Provider Legal NameDYLAN WALLACECredential: LCSW, QCSW
Location Address34 MAIN STREET EXT STE 104Plymouth, MA 02360-3375
Mailing Address1469 N 1200 WOrem, UT 84057-2449 · (801) 655-5450 · Fax (385) 225-9327
Phone(801) 655-5450
Fax(385) 225-9327
Sole ProprietorNo
Medical School CMSOtherGraduated 2013
Enumeration DateMay 3, 2019
Last NPPES UpdateApril 2, 20264 updates tracked since enumeration
NPPES CertifiedApril 2, 2026
✔ NPI 1982269155 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
Licenses✔ Licensed in MA · LICSW126861✔ Licensed in WA · SWI.LW.61224850✔ Licensed in FL · SW15210✔ Licensed in ID · 3381901✔ Licensed in UT · 11338410-3501
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.
34 MAIN STREET EXT STE 104, Plymouth, MA 02360
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Other Names 1

Other Name (5)Dylan Shane Wallace

Secondary Practice Location 1

Location 11469 N 1200 WOrem, UT 84057-2449 · Phone (801) 655-5450 · Fax (385) 225-9327

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Blue Cross Blue Shield of Arizona, BridgeSpan Health Company and more.Insurance ›

Medicare Participation & PECOS CMS

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

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.

PECOS PAC ID3173060076
PECOS Enrollment IDI20240808001881, I20260221000244
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.

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.

New Patient
$0.00 typical visit price
range $58.86 – $177.36
Typical copayment $0.00 (range $14.71 – $44.34)
Most-billed visit code NA
Established Patient
$73.22 typical visit price
range $19.11 – $144.84
Typical copayment $18.30 (range $4.77 – $36.21)
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

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

MEADOWBROOK COUNSELING OF MASSACHUSETTS, LLC
Social Worker (Clinical)
34 MAIN STREET EXT STE 104
PLYMOUTH, MA 02360
Plymouth County (801) 655-5450

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.

What insurance does Dylan Wallace accept?

Health plans from Anthem Blue Cross and Blue Shield, Blue Cross Blue Shield of Arizona, BridgeSpan Health Company, Harvard Pilgrim Health Care and Molina Healthcare and 5 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 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.