Codie Wallace, MSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCSW 800 Issued in WY

Practice address

2510 E 15TH St
Suite 11
Casper, WY 82609-4111

Phone

(307) 234-9979

Fax

(307) 234-9989

NPI assigned

Jan 6, 2009

Last updated

Sep 21, 2012By the provider in NPPES

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

Other names 1

• Codie Wallace Professional name

Medicare fee-for-service enrollment

Enrolled in WY

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, 2009

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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

• Campbell County Hospital District

  dba Campbell County Medical Group - Internal Medicine Clinic

  • Internal Medicine Physician
  • Gillette, WY
  • NPI 1710098868
  Medicare reassignment
• Complete Care Counseling, LLC

  • Clinical Social Worker
  • Casper, WY
  • NPI 1972854800
  Authorized official Same address or phone

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

{
    "created_epoch": "1231200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348185600000",
    "number": "1073759429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2510 E 15TH ST",
            "address_2": "SUITE 11",
            "city": "CASPER",
            "state": "WY",
            "postal_code": "826094111",
            "telephone_number": "307-234-9979",
            "fax_number": "307-234-9989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2510 E 15TH ST",
            "address_2": "SUITE 11",
            "city": "CASPER",
            "state": "WY",
            "postal_code": "826094111",
            "telephone_number": "307-234-9979",
            "fax_number": "307-234-9989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "CODIE",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-01-06",
        "last_updated": "2012-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WY",
            "license": "LCSW 800",
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CODIE",
            "last_name": "WALLACE",
            "credential": "LCSW",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Walgreen Co (Walgreens #07462)
• Anita Walker, CCC-SLP
• Debra Walker, PA-C
• Kasey Maria Walker
• William Walker
• Sara Beth Wallin, B.S.
• Walmart Inc. (Walmart Pharmacy 10-1617)
• Walmart Inc. (Walmart Pharmacy 10-3778)
• Walmart, Inc.
• Patricia Anne Walton, FNP-BC

• Clinical Social Worker in Casper, WY
• Providers in Casper, WY by specialty
• Clinical Social Worker in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2012; 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.