Caitlyn Wallace, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

0904019712 Issued in VA

Practice address

3910 Old Buckingham Rd
Powhatan, VA 23139-5757

Phone

(804) 598-2200

NPI assigned

Dec 29, 2025

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

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, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

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.

• Goochland Powhatan Community Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Goochland, VA
  • NPI 1467448571
  Medicare reassignment NPD
• Goochland County Board of Supervisors

  • Ambulance
  • Goochland, VA
  • NPI 1689928129
  NPD (past)

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

{
    "created_epoch": "1766966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767139200000",
    "number": "1013873579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3910 OLD BUCKINGHAM RD STE A",
            "city": "POWHATAN",
            "state": "VA",
            "postal_code": "231395757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3910 OLD BUCKINGHAM RD",
            "city": "POWHATAN",
            "state": "VA",
            "postal_code": "231395757",
            "telephone_number": "804-598-2200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "CAITLYN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-12-29",
        "last_updated": "2025-12-31",
        "certification_date": "2025-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904019712",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Virginia Innovative Pain and Spine
• Virginia Physicians, Inc
• Virtual Foot and Ankle Care, LLC
• Wal-Mart Stores East LP
• Wal-Mart Stores East LP
• Wanda a. Crockett PLLC
• Christopher R Ward, DDS
• Well Beyond Physical Therapy
• Wellness First, Incorporated
• Erin Wheeler

• Clinical Social Worker in Powhatan, VA
• Providers in Powhatan, VA by specialty
• Clinical Social Worker in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2025; 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.