Individual
DYLAN WALLACE
Active
Individual
DYLAN WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW, QCSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
11338410-3501
UT
1041C0700X
Clinical Social Worker
3381901
ID
1041C0700X
Clinical Social Worker
LCSW-22060
AZ
1041C0700X
Clinical Social Worker
Primary
LICSW126861
MA
1041C0700X
Clinical Social Worker
LW61224850
WA
1041C0700X
Clinical Social Worker
SW15210
FL
1041C0700X
Clinical Social Worker
SWI.LW.61224850
WA
Other
Enumeration date
05/03/2019
Last updated
04/02/2026
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up