Patricia Wallace, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

44SL05298500 Issued in NJ

Practice address

3 Stearns Rd
East Brunswick, NJ 08816-4167

Phone

(732) 406-3515

NPI assigned

Jan 12, 2009

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

• Patricia Alagna Former name

Medicare fee-for-service enrollment

Enrolled in NJ

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

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.

• Middlesex Psychiatry & TMS PC

  • Psychiatry Physician
  • Fairfield, NJ
  • NPI 1053971572

  NJ

  Medicare reassignment NPD
• NJ Behavioral Health Services PC

  • Clinical Psychologist
  • Paramus, NJ
  • NPI 1447289376

  Clinical

  NPD (past)
• Tolchin Psychological Services, P.C.

  • Health Service Psychologist
  • Hauppauge, NY
  • NPI 1356162036
  NPD (past)

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

{
    "created_epoch": "1231718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688515200000",
    "number": "1992942007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 STEARNS RD",
            "city": "EAST BRUNSWICK",
            "state": "NJ",
            "postal_code": "088164167",
            "telephone_number": "732-406-3515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 STEARNS RD",
            "city": "EAST BRUNSWICK",
            "state": "NJ",
            "postal_code": "088164167",
            "telephone_number": "732-406-3515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "PATRICIA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-01-12",
        "last_updated": "2023-07-05",
        "certification_date": "2023-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC05346300",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SL05298500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PATRICIA",
            "last_name": "ALAGNA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Wal-Mart Stores East LP
• Wal-Mart Stores East, LP
• Frederick A Waldron, MD
• Walgreen Eastern Co, Inc
• Lacey Marie Wallace-Czirjak, LCSW
• David Michael Walor, MD
• Aihong Wang
• Stephen William Warren, MD
• William R Wasserstrom, MD
• Risa B Waters, LMSW

• All providers in East Brunswick, NJ
• Clinical Social Worker in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.