Carly J Wallace (NPI# 1780040600, PAC ID# 9931466158) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is CLINICAL SOCIAL WORKER.
| Nation Provider ID (NPI) | 1780040600 |
| PAC ID by PECOS | 9931466158 |
| Professional Enrollment ID | I20171127000818 |
| Full Name | Carly J Wallace |
| Organization Legal Name | SOUTH BAY MENTAL HEALTH CENTER, INC. |
| Address |
340 Main St Suite 818 Worcester MA 01608-1604 |
| Phone Number | 5087914976 |
| Gender | F |
| Graduation Year | 2013 |
| Primary Specialty | CLINICAL SOCIAL WORKER |
| Group Practice PAC ID | 5395797310 |
| Number of Group Practice Members | 30 |
| Accepts Medicare Assignment | Y |
| Address | Phone | Organization |
|---|---|---|
| 340 Main St, Suite 818, Worcester, MA 01608-1604 | 5087914976 | SOUTH BAY MENTAL HEALTH CENTER, INC. |
| Organization Legal Name | SOUTH BAY MENTAL HEALTH CENTER, INC. |
| Physicians | 52 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| William P Dempsey | Clinical Social Worker | South Bay Mental Health Center, Inc. | 415 Neponset Ave, Suite 3, Dorchester, MA 02122-3169 |
| Michael P Delisle | Nurse Practitioner | South Bay Mental Health Center, Inc. | 22 Old Canal Dr, Lowell, MA 01851-2730 |
| Christina E Stang | Clinical Social Worker | South Bay Mental Health Center, Inc. | 607 Pleasant St, Suite 115, Attleboro, MA 02703-2570 |
| Itoko Kikuchi | Nurse Practitioner | South Bay Mental Health Center, Inc. | 181 Union St, Suite J, Lynn, MA 01901-1311 |
| Jenny C Hunt | Clinical Social Worker | South Bay Mental Health Center, Inc. | 70 Everett Ave, Suite 515, Chelsea, MA 02150-2363 |
| Laura E Adams | Clinical Social Worker | South Bay Mental Health Center, Inc. | 50 Aldrin Rd, Plymouth, MA 02360-4827 |
| Farah Desrosiers | Nurse Practitioner | South Bay Mental Health Center, Inc. | 103 Commercial St, Brockton, MA 02302-3101 |
| Christina M Desantis | Clinical Social Worker | South Bay Mental Health Center, Inc. | 35 Congress St, Suite 225, Salem, MA 01970-5529 |
| Michele M Byrnes | Clinical Social Worker | South Bay Mental Health Center, Inc. | 324 Clark St, Fl 2, Worcester, MA 01606-1214 |
| Jennifer L Lawrence | Clinical Social Worker | South Bay Mental Health Center, Inc. | 61 Industrial Park Rd, Plymouth, MA 02360-7246 |
| Street Address |
340 MAIN ST SUITE 818 |
| City | WORCESTER |
| State | MA |
| Zip | 01608-1604 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Joyce K George | Psychologist, Clinical | 340 Main St, Suite 807, Worcester, MA 01608-1606 | |
| Jean L Moffatt | Clinical Social Worker | 340 Main St, Saugerties, NY 12477-1406 | |
| Karen L St Laurent | Chiropractic | 340 Main St, Suite 510, Worcester, MA 01608-1694 | |
| Arthur F Losapio | Clinical Social Worker | Cedar Street Family Clinic Inc | 340 Main St, Suite 869, Worcester, MA 01608-1601 |
| Scott A Darragh | Chiropractic | 340 Main St, 102 Bay State Ctr Fam, Melrose, MA 02176-4661 | |
| Rachel Wolfield | Clinical Social Worker | Glens Falls Hospital Inc | 340 Main St, Hudson Falls, NY 12839-1530 |
| Vivian Chou | Obstetrics/gynecology | 340 Main St, Madison, NJ 07940-2363 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Stacey B Roberts | Psychologist, Clinical | 51 Union St, Suite 214, Worcester, MA 01608-1100 | |
| Kathryn W Deliso | Optometry | Mcphs University | 10 Lincoln Sq, Worcester, MA 01608-1135 |
| Richard Martino | Optometry | Mcphs University | 10 Lincoln Sq, Worcester, MA 01608-1135 |
| Angela Imperioli | Optometry | Mcphs University | 10 Lincoln Sq, Worcester, MA 01608-1135 |
| Mary Gilman | Optometry | Mcphs University | 10 Lincoln Sq, Worcester, MA 01608-1135 |
| Caroline J Toomey-gitto | Optometry | Mcphs University | 10 Lincoln Sq, Worcester, MA 01608-1135 |
| Joseph M Stamm | Optometry | Mcphs University | 10 Lincoln Sq, Worcester, MA 01608-1135 |
| Heather A Bell | Optometry | Mcphs University | 10 Lincoln Sq, Worcester, MA 01608-1135 |
| Jami Parsons Malloy | Optometry | Mcphs University | 10 Lincoln Sq, Worcester, MA 01608-1135 |
| Kathryn M Chehade | Optometry | Mcphs University | 10 Lincoln Sq, Worcester, MA 01608-1135 |
| Find all physicians in zip 01608 | |||
| City | WORCESTER |
| Zip Code | 01608 |
| Specialty | CLINICAL SOCIAL WORKER |
| City + Specialty | WORCESTER + CLINICAL SOCIAL WORKER |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.