Individual provider · Type 1 NPI

Dylan Wallace, LCSW, QCSW

Clinical Social Worker · Plymouth, MA

NPI number 1982269155 Active

Practice location

34 Main Street Ext Ste 104
Plymouth, MA 02360-3375

Call (801) 655-5450 Map

Fax (385) 225-9327

Mailing address

1469 N 1200 W
Orem, UT 84057-2449

Other practice locations

  • 1469 N 1200 W, Orem, UT 84057-2449 · (801) 655-5450

Specialties and licenses

TaxonomyCodeLicense
Clinical Social Worker 1041C0700XSWI.LW.61224850 (WA)
Clinical Social Worker Primary 1041C0700XLICSW126861 (MA)
Clinical Social Worker 1041C0700XSW15210 (FL)
Clinical Social Worker 1041C0700X3381901 (ID)
Clinical Social Worker 1041C0700X11338410-3501 (UT)

Clinical Social Worker: 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 interpers…

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About NPI 1982269155

Dylan Wallace, LCSW, QCSW's National Provider Identifier is 1982269155, issued on May 3, 2019. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in Plymouth, MA. The record was last updated on Apr 2, 2026.