Divinity Star, LCSW is a medicare enrolled "Social Worker - Clinical" provider in Pasadena, California. She graduated from healthcare school in 2017 and has 7 years of diverse experience with area of expertise as Clinical Social Worker. She is a member of the group practice Providence Facey Medical Foundation and her current practice location is
2650 E Foothill Blvd, Pasadena, California. You can reach out to her office (for appointments etc.) via phone at
(626) 577-2261.
Divinity Star is licensed to practice in California (license number 104320) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1124501697.
Healthcare Provider's Profile
Full Name | Divinity Star |
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Gender | Female |
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Speciality | Clinical Social Worker |
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Experience | 7 Years |
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Location | 2650 E Foothill Blvd, Pasadena, California |
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Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Medical Education and Training:
- Divinity Star graduated from medical school in 2017
NPI Data:
- NPI Number: 1124501697
- Provider Enumeration Date: 09/11/2018
- Last Update Date: 10/04/2021
Medicare PECOS Information:
- PECOS PAC ID: 3971996737
- Enrollment ID: I20220131002564
Medical Identifiers
Medical identifiers for Divinity Star such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1124501697 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
101YM0800X | Counselor - Mental Health | 80527 (California) | Secondary |
1041C0700X | Social Worker - Clinical | 104320 (California) | Primary |
Group Practice Association
Group Practice Name | Group PECOS PAC ID | No. of Members |
Providence Facey Medical Foundation | 3173436276 | 282 |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Divinity Star allows following entities to bill medicare on her behalf.
Entity Name | Providence Facey Medical Foundation |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1710031588 PECOS PAC ID: 3173436276 Enrollment ID: O20031105000822 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Divinity Star is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Divinity Star, LCSW 2650 E Foothill Blvd, Pasadena, CA 91107-3439 Ph: () - | Divinity Star, LCSW 2650 E Foothill Blvd, Pasadena, CA 91107-3439 Ph: (626) 577-2261 |
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