Candace Nicole Wallis
NPI 1215691597ActiveIndividual· Social Worker, Clinical· Coos Bay, OR
Social Worker, Clinical with Coastal Center, LLC., practicing in Coos Bay, Oregon. Enrolled in Medicare as practitioner - clinical social worker.
Overview
| NPI | 1215691597 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Sole proprietor | No |
| NPI issued | Oct 24, 2021 |
| Last updated in NPPES | Oct 24, 2021 |
| Certified by provider | Oct 24, 2021 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Social Worker, Clinical Primary | 1041C0700X | 15085 | FL |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Clinical Social Worker (OR) |
|---|
Education and affiliations
| Graduation year | 2020 |
|---|---|
| Medicare specialty | Clinical Social Worker |
Medical group
- Coastal Center, LLC.North Bend, OR · 5 clinicians
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All 40 clinical social workers in Coos Bay · All clinical social workers in Oregon