Shana Wallace

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Practice address

417 Liberty St
Springfield, MA 01104-3736

Phone

(413) 246-9675

NPI assigned

May 23, 2019

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 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, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

James Levine and Associates P CGroup PAC ID 8729065388, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Advanced Behavioral Health Group, Ma P.C.

  • Mental Health Counselor
  • South Hadley, MA
  • NPI 1437266871
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1558569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630627200000",
    "number": "1922665173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "417 LIBERTY ST",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011043736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "417 LIBERTY ST",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011043736",
            "telephone_number": "413-246-9675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "SHANA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-23",
        "last_updated": "2021-09-03",
        "certification_date": "2021-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachel Walker
• Sanyu Haffusa Walker, APRN
• Sarah Ellen Walker, M.S.W.
• Mael Walkowiak, PA
• Jennifer M Wallace, NP
• Stacey Waller
• Laura Wallis, LICSW
• Aubrea Walsh, DPT
• Christa Grace Walsh
• Gabryjela Walsh

• Clinical Social Worker in Springfield, MA
• Providers in Springfield, MA by specialty
• Clinical Social Worker in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2021; 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.