Dana Wallace, LCSW, LICSW
Individual provider Active NPI Clinical Social Worker · Fort Walton Beach, FL
NPI 1144747205 · NPPES record last updated May 6, 2026
Key facts
- NPI
- 1144747205
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- SW24920 (FL)
- Practice address
- 480 Santa Rosa Blvd
Fort Walton Beach, FL 32548-6901 - Phone
- (251) 421-0712
- NPI assigned
- Aug 29, 2017
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Clinical Social Worker
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Bluewater Behavioral Health, Inc.
Practice addresses (Care Compare)
907 Mar Walt Dr
Suite 2013
Fort Walton Beach, FL 32547-6756
Phone (850) 797-2598
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250625004301 | FL | Practitioner - Clinical Social Worker | 3476065210 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6143C | AL | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dana J. Wallace, LCSW, LLC | Clinical | Current | Accepting new patients |
| Bluewater Behavioral Health Inc | Current |
Accepting new patients |
Locations
907 Mar Walt Dr
Ste 2013
Fort Walton Beach, FL 32547
Phone (850) 249-4300
480 Santa Rosa Blvd
Unit 308E
Fort Walton Beach, FL 32548
Phone (251) 421-0712
4400 E Highway 20
Ste 306
Niceville, FL 32578
Phone (850) 797-2598
4400 E Highway 20
Ste 208
Niceville, FL 32578
Phone (507) 972-5988
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | SW24920 | FL | Yes |
| Clinical Social Worker | 1041C0700X | 6143C | AL |
Addresses
Primary practice location
480 Santa Rosa Blvd
Fort Walton Beach, FL 32548-6901
Mailing address
480 Santa Rosa Blvd Unit 308E
Fort Walton Beach, FL 32548-6945
Phone (251) 421-0712
Other providers in Fort Walton Beach, FL
- Marilyn C Walker
- Miranda Walker
- Renee M Walker
- Stanley C Walker
- Tehra McClellan Walker
- Rachael Wallace
- Kaylie Marie Walsh
- Bin Wang
- Yuan Wang
- Angela S Wanless
All providers in Fort Walton Beach, FL · Clinical Social Worker in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 6, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.