Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mr. Jeffrey Michael Wallach, LCSW-R

Individual provider Clinical Social Worker · NPI 1407952054

Mr. Jeffrey Michael Wallach, LCSW-R is a Clinical Social Worker in Brooklyn, New York. Qualified in 1979, 47 years ago. Practices with Interborough Developmental and Consultation Center Inc, a 152-clinician group, accepts Medicare assignment and offers telehealth. Licensed in New York.

Years since qualifying
47
Licensed in
NY
In the registry since
2006
Specialties on file
2
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Practice location Address checks out

1670 E 17th St # 78 Interborough Developmental And Consultation Center
Brooklyn, NY 11229-1258
Phone: (917) 502-0762
Fax: (718) 245-2517
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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 R 023720-1 (NY)
Clinical Social Worker Taxonomy 1041C0700X · Licence 023720-1 (NY)

Record details

NPI number1407952054
Entity typeIndividual (Type 1)
GenderMale
Credentials LCSW-R
Sole proprietorYes
NPI enumeratedSeptember 14, 2006
Last updated in NPPESJuly 8, 2007

Medicare enrollment

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

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 1979 (47 years in practice)
Group practice Interborough Developmental And Consultation Center Inc — 152 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

Other providers in Brooklyn