Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Garret Wallace

Individual provider Clinical Social Worker · NPI 1366179764

Garret Wallace is a Clinical Social Worker in Boston, Massachusetts. Qualified in 2019, 7 years ago. Practices with Fenway Community Health Center, Inc, a 81-clinician group and accepts Medicare assignment. Licensed in Massachusetts.

Years since qualifying
7
Licensed in
MA
In the registry since
2022
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Practice location Address checks out

1340 Boylston St
Boston, MA 02215-4302
Phone: (857) 316-9173
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 227331 (MA)

Record details

NPI number1366179764
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedAugust 4, 2022
Last updated in NPPESSeptember 8, 2025
Certification dateSeptember 8, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Fenway Community Health Center, Inc — 81 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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