Felicia Lee Wallace, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Practice address

100 Emancipation Dr
BLDG 71
Hampton, VA 23667-0001

Phone

(757) 722-9961

NPI assigned

Apr 17, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

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, 2005

Medicare assignment

May accept Medicare assignment

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.

• Nexumhc Consultants, PLLC

  • Clinical Social Worker
  • Lincolnwood, IL
  • NPI 1851082598
  Medicare reassignment NPD
• Peace of Mind Mental Health Services LLC

  • Counselor
  • Hampton, VA
  • NPI 1053996231
  NPD (past)

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

{
    "created_epoch": "1334620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744070400000",
    "number": "1215294152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 EMANCIPATION DR",
            "address_2": "BLDG 71",
            "city": "HAMPTON",
            "state": "VA",
            "postal_code": "236670001",
            "telephone_number": "757-722-9961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 EMANCIPATION DR",
            "address_2": "BLDG 71",
            "city": "HAMPTON",
            "state": "VA",
            "postal_code": "236670001",
            "telephone_number": "757-722-9961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "FELICIA",
        "middle_name": "LEE",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-17",
        "last_updated": "2025-04-08",
        "certification_date": "2025-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149028883",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904018214",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Raven Walker, RN
• Shayla Walker, LCSW
• David Roy Wall, MSW
• Lisa G. Wallace-Davis, OD
• David Michael Wallace Sr., M.D.
• Selina Samantha Wallace
• Kenneth William Waller, M.D.
• Walter Rudolph Wallingford, M.D.
• Gloria Walters, M.D.
• Betty R. Walton, M.A. CCC-SLP

• Clinical Social Worker in Hampton, VA
• Providers in Hampton, 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 Apr 8, 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.