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

Mrs. Elaine Marie Wallace, LCPC

Individual provider Professional Counselor · NPI 1962084574

Mrs. Elaine Marie Wallace, LCPC is a Mental Health Counselor in Glen Burnie, Maryland. Qualified in 2020, 6 years ago. Practices with Mental Health Specialty Group PA, a 679-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Maryland.

Years since qualifying
6
Licensed in
MD
In the registry since
2021
What do these letters mean?
LCPC — Licensed Clinical Professional Counselor
A licensed clinical counsellor.

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Practice location Address checks out

204 Somerset Bay Dr Apt 201
Glen Burnie, MD 21061-6476
Phone: (410) 903-8473
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Professional Counselor (primary) Taxonomy 101YP2500X · Licence LC13561 (MD)

Record details

NPI number1962084574
Entity typeIndividual (Type 1)
GenderFemale
Credentials LCPC
Sole proprietorYes
NPI enumeratedApril 22, 2021
Last updated in NPPESAugust 29, 2023
Certification dateAugust 29, 2023

Medicare enrollment

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

Medicare specialtyMENTAL HEALTH COUNSELOR
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Mental Health Specialty Group Pa — 679 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations4 on file with Medicare

Other providers in Glen Burnie