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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

DYLAN WALLACE, LCSW, QCSW

Active Sole Proprietor

DYLAN WALLACE, LCSW, QCSW is a Clinical Social Worker healthcare provider located in PLYMOUTH, Massachusetts. NPI 1982269155 is currently active in the NPPES registry. Verify at CMS.

Clinical Social Worker · PLYMOUTH, MA

Registration Details

NPI Number
1982269155
Provider Type
Individual
Gender
Male
NPI Issued
May 3, 2019 (7.3063885602328 yrs)
Last Updated
Dec 30, 2024
Licenses
SW15210 (FL)
LCSW-22060 (AZ)
LICSW126861 (MA)
LW61224850 (WA)
11338410-3501 (UT)
Sole Proprietor
Yes

Practice Information

Address
34 MAIN STREET EXT STE 104
PLYMOUTH, MA, 023603375
Browse MA providers · Browse ZIP 02360
Phone
8016555450
Fax
3852259327
Primary Specialty
Clinical Social Worker
1041C0700X
Additional Specialty
Clinical Social Worker
Additional Specialty
Clinical Social Worker
Additional Specialty
Clinical Social Worker
Additional Specialty
Clinical Social Worker

Other Clinical Social Worker Providers in PLYMOUTH, MA

Name Credential NPI
MS. ELLEN M. BARRESI MSW, LICSW 1508844705
MS. KAREN E TRAIS LICSW 1881665578
MS. DIANNE SENTER LOCKWOOD LICSW 1114986189
MRS. MARY LOU SHEWCHUK LICSW 1942251103
MRS. KRISTIN HALLETT LICSW 1184675753
MRS. MARCIA S. BAUM LICSW 1346264231
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.