BRIAN WAHL (LCSW) – Clinical Social Worker, NPI 1750757373

BRIAN WAHL (LCSW) is a healthcare provider. based in Daytona beach, Florida. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials LCSW. They hold a License No. SW12336 (FL). The NPI Number for BRIAN WAHL (LCSW) is 1750757373

Main info

Male
14 Years Of Experience
Accepts Medicare Assignment
Name
BRIAN WAHL (LCSW)
NPI
1750757373
Phone
Not provided
Address
1220 WILLIS AVE
Enumeration Date
18 August 2015
Last Update Date
18 August 2015

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4077562084
Graduation Year
2012 (14 years ago)
PAC ID
2567772296
Group Practice PAC ID
9032525969
Professional Enrollment ID
I20151110001509
Address ID
FL327514761MA341XXAVEX401
Telehealth
Yes
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience34
Completeness75
Years active:10State licenses:1Digital endpointsOther names

3,374 CLINICAL SOCIAL WORKER in FL

Provider Addresses for BRIAN WAHL (LCSW)

  • 1220 WILLIS AVE

    DAYTONA BEACH, FL 321142810

    Phone:

    Type: Mailing

  • 356 ENGLENOOK DR

    DEBARY, FL 327131805

    Phone: (386) 236-3200

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2015-11-10

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20151110001509IClinical Social WorkerFLTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 32114)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 9032525969View full group profile
NameSpecialtyState
Nurse PractitionerFL
Clinical PsychologistND
Clinical Social WorkerFL
Clinical PsychologistFL
Clinical Social WorkerFL

Reviews

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Frequently asked questions

What identifier follows BRIAN WAHL (LCSW) across health systems?
The NPI 1750757373 uniquely identifies BRIAN WAHL (LCSW) in U.S. healthcare data.
Does the public listing show BRIAN WAHL (LCSW) as active?
BRIAN WAHL (LCSW)'s NPI record reflects an active status in NPPES.
What type of care does BRIAN WAHL (LCSW) provide?
BRIAN WAHL (LCSW)'s profile centers on Clinical Social Worker. Clinical services aligned with this taxonomy classification.
Which community is linked to BRIAN WAHL (LCSW)?
BRIAN WAHL (LCSW) shows a connection to Daytona Beach, Florida in registry-derived data.
Who maintains BRIAN WAHL (LCSW)'s record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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