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

Individual provider Clinical Social Worker · NPI 1841313590

Jody Lynn Wallace, LICSW is a Clinical Social Worker in Amherst, Massachusetts. Qualified in 2002, 24 years ago. Practices with Amherst Psychotherapy Practice PC, a 24-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Massachusetts.

Years since qualifying
24
Licensed in
MA
In the registry since
2007
What do these letters mean?
LICSW — Licensed Independent Clinical Social Worker
The title some states use for an independently practising clinical social worker.

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Practice location Address checks out

48 N Pleasant St Ste 207
Amherst, MA 01002-1741
Phone: (413) 461-4042
Fax: (413) 726-6001
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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 113344 (MA)

Record details

NPI number1841313590
Entity typeIndividual (Type 1)
GenderFemale
Credentials LICSW
Sole proprietorNo
NPI enumeratedApril 9, 2007
Last updated in NPPESOctober 14, 2019

Medicare enrollment

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

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2002 (24 years in practice)
Group practice Amherst Psychotherapy Practice Pc — 24 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

Other providers in Amherst