Elisabeth Neelon Wallace, LICSW

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

1023735 Issued in MA

Practice address

481 Concord Ave
Lexington, MA 02421-8007

Phone

(781) 354-7327

NPI assigned

Dec 29, 2006

Last updated

Oct 9, 2012By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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 MA

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, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Atrius Health IncGroup PAC ID 4789588641, 1,214 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ewallacelicsw282597@direct.atrius.masshiway.net

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.

• Atrius Health, Inc.

  • Internal Medicine Physician
  • Boston, MA
  • NPI 1871639914
  Medicare reassignment Care Compare group NPD
• Thrive Counseling LLC

  dba Thriveworks

  • Mental Health Counselor
  • Lynchburg, VA
  • NPI 1215181300

  MA

  Medicare reassignment NPD
• Atrius Health, Inc.

  dba Harvard Vanguard Medical Associates

  • Internal Medicine Physician
  • Beverly, MA
  • NPI 1114265634
  NPD
• Atrius Health, Inc.

  dba Harvard Vanguard Medical Associates

  • Radiation Oncology Physician
  • Weymouth, MA
  • NPI 1609991439
  NPD
• New England Allergy,Asthma,Immunology and Primary Care P.C.

  • Specialist
  • North Andover, MA
  • NPI 1114009339
  NPD (past)

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

{
    "created_epoch": "1167350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349740800000",
    "number": "1497811822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "481 CONCORD AVE",
            "city": "LEXINGTON",
            "state": "MA",
            "postal_code": "024218007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "481 CONCORD AVE",
            "city": "LEXINGTON",
            "state": "MA",
            "postal_code": "024218007",
            "telephone_number": "781-354-7327"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "ELISABETH",
        "middle_name": "NEELON",
        "name_prefix": "Ms.",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-29",
        "last_updated": "2012-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MA",
            "license": "1023735",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hilde Waerstad, MSPT
• Sarah Marie Wahlen
• Rosette Wakanabo, RN
• Jane Lori Waldman, PSYD
• Walgreen Eastern Co Inc (Walgreens #01863)
• Wallis Dental LLC
• Regina Walsh Troast
• Rliey Patrick Walsh
• Sean Walsh
• Yi CHI Wang, DDS

• Mental Health Counselor in Lexington, MA
• Providers in Lexington, MA by specialty
• Mental Health Counselor in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 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.