DYLAN WALLACE LCSW QCSW NPI 1982269155

NPI Information

  • NPI: 1982269155
  • Provider Name: DYLAN WALLACE, LCSW, QCSW
  • Classification: Social Worker - 1041C0700X
  • Specialization: Clinical
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 34 MAIN STREET EXT STE 104
    PLYMOUTH, MA
    ZIP 02360
  • Phone: (801) 655-5450

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NPI Details

Dylan Wallace, LCSW, QCSW is a clinical social worker in Plymouth, MA. The provider is a social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. Dylan Wallace, LCSW, QCSW NPI is 1982269155. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

34 MAIN STREET EXT STE 104
PLYMOUTH, MA
ZIP 02360-375
Phone: (801) 655-5450
Fax: (385) 225-9327

The NPI 1982269155 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment.

The enumeration date for this NPI number is 5/3/2019 and was last updated on 12/30/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11041C0700XSocial WorkerClinicalSW15210FLORIDANo
21041C0700XSocial WorkerClinicalLCSW-22060ARIZONANo
31041C0700XSocial WorkerClinicalLICSW126861MASSACHUSETTSNo
41041C0700XSocial WorkerClinicalLW61224850WASHINGTONNo
51041C0700XSocial WorkerClinical11338410-3501UTAHYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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