Michelle Wallace, LCSW
Michelle Wallace, LCSW is a provider specialising in Clinical Social Worker in Bend, OR, registered under NPI 1336796374. This provider registers 2 separate taxonomy codes, which usually means they practise across more than one recognised specialty.
Getting there
The practice address on file is 1340 NW WALL ST, Bend, OR 97703. We have not yet mapped what surrounds this office — parking, transit, and nearby pharmacies are added as our data collection reaches each location.
Credentials and Medicare
| Licence | State | Specialty |
|---|---|---|
| L11322 | OR | Clinical Social Worker primary |
This provider holds licence L11322 issued in OR. A licence number in NPPES reflects what was filed at registration — it does not confirm the licence is still active today.
- Status
- Approved
- Provider type
- Practitioner - Clinical Social Worker
- PAC ID
- 4385009323
Medicare enrolment is recorded as approved under the provider type Practitioner - Clinical Social Worker. This means the provider is enrolled to bill Medicare, though it does not tell you whether they are currently accepting new Medicare patients. Call the office to confirm.
What Clinical covers
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. NUCC Health Care Provider Taxonomy, code 1041C0700X
All registered taxonomy codes
This provider registers 2 taxonomy codes. The primary code is what appears on most claims; the others record additional recognised specialties.
| Code | Specialty | Licence | State | |
|---|---|---|---|---|
| 1041C0700X | Clinical Social Worker Clinical | L11322 | OR | primary |
| 101YM0800X | Mental Health Counselor Mental Health | — | — |
The taxonomy records how the provider classifies their own practice. It does not confirm which conditions they currently treat, whether they are accepting new patients, or which insurance they take — call the office for that.
Full NPPES record
An NPI-1 identifies a single person. It stays with the clinician for life, even if they move practice or change state, which is why the address on file can lag behind where they actually work today.
| NPI | 1336796374 valid check digit |
|---|---|
| Entity type | Individual (NPI-1) |
| Enumeration date | Aug 23, 2019 |
| Last updated | Apr 17, 2023 |
| Status | Active |
| Sole proprietor | No |
| Credential | LCSW |
| Practice address |
1340 NW WALL ST Bend, OR 97703 (541) 322-7500 Fax (541) 322-7565 |
| Mailing address |
2577 NE COURTNEY DR Bend, OR 97701 |
Number check
How the check works, step by step
Every NPI carries a Luhn check digit — the same scheme used on credit cards. CMS prefixes the number with 80840 before computing it, which marks it as a US health identifier.
| Digit | 8 | 0 | 8 | 4 | 0 | 1 | 3 | 3 | 6 | 7 | 9 | 6 | 3 | 7 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Doubled? | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 |
| Value | 8 | 0 | 8 | 8 | 0 | 2 | 3 | 6 | 6 | 5 | 9 | 3 | 3 | 5 |
Sum = 66 · next multiple of 10 = 70 · check digit = 4 · actual last digit = 4
A valid check digit only means the number is well-formed. It does not mean the provider is licensed, active, or in good standing — those are separate questions answered by the sections above.