Monica Wallace, LMSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

6801096486 Issued in MI

Practice address

38600 Van Dyke Ave Ste 101
Sterling Heights, MI 48312-1171

Phone

(800) 693-1916

NPI assigned

Nov 9, 2016

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Richard Kneip PHD PCGroup PAC ID 4880768415, 243 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Richard Kneip, PH.D., P.C.

  • Community/Behavioral Health Agency
  • Clarkston, MI
  • NPI 1679739700
  Medicare reassignment Care Compare group NPD
• Connections Counseling Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Clinton Township, MI
  • NPI 1285450692
  NPD Authorized official
• Bethany Christian Services

  • Clinical Social Worker
  • Detroit, MI
  • NPI 1235479700
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1478649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672876800000",
    "number": "1013459940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30243 CAMPBELL ST",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480932585",
            "telephone_number": "810-305-8531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "38600 VAN DYKE AVE STE 101",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483121171",
            "telephone_number": "800-693-1916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "MONICA",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-09",
        "last_updated": "2023-01-05",
        "certification_date": "2023-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801096486",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801096486",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ross Pearson Walker, DPT, OMPT
• Samuel Walker, LLCP
• Marlana Kay Wall-Ketelhut, MA, LLPC, LBSW
• Gayle Ann Wallace, PTA
• Howard S Wallace, M.D.
• Gary Waller, ATC
• Susan Wallner
• Brenda Walls
• Abigail Walter
• Ebony Walton

• Social Worker in Sterling Heights, MI
• Providers in Sterling Heights, MI by specialty
• Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.