Ebony Nicole Calloway, LICSW in Dumfries, VA - Medicare Social Worker Provider

Ebony Nicole Calloway, LICSW is a medicare enrolled "Social Worker - Clinical" provider in Dumfries, Virginia. Her current practice location is 16712 Jefferson Davis Hwy, Dumfries, Virginia. You can reach out to her office (for appointments etc.) via phone at (703) 221-7467.

Ebony Nicole Calloway is licensed to practice in Virginia (license number 0904010339) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1467987974.

Contact Information

	Ebony Nicole Calloway, LICSW
	16712 Jefferson Davis Hwy, Dumfries, VA 22026-2115
	(703) 221-7467
	(703) 221-4115

Map and Direction

Healthcare Provider's Profile

Full Name	Ebony Nicole Calloway
Gender	Female
Speciality	Social Worker - Clinical
Location	16712 Jefferson Davis Hwy, Dumfries, Virginia
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1467987974
Provider Enumeration Date: 04/22/2017
Last Update Date: 03/14/2024

Medicare PECOS Information:

PECOS PAC ID: 5294002549
Enrollment ID: I20201112000076

Medical Identifiers

Medical identifiers for Ebony Nicole Calloway such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1467987974	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
1041C0700X	Social Worker - Clinical	SW12357 (Florida)	Secondary
1041C0700X	Social Worker - Clinical	LC50080428 (District Of Columbia)	Secondary
1041C0700X	Social Worker - Clinical	0904010339 (Virginia)	Primary

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. Ebony Nicole Calloway allows following entities to bill medicare on her behalf.

Entity Name	Della Behavioral Health Services
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1750635207 PECOS PAC ID: 3971755000 Enrollment ID: O20121218000204

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. Ebony Nicole Calloway 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
Ebony Nicole Calloway, LICSW 16712 Jefferson Davis Hwy, Dumfries, VA 22026-2115 Ph: (703) 221-7467	Ebony Nicole Calloway, LICSW 16712 Jefferson Davis Hwy, Dumfries, VA 22026-2115 Ph: (703) 221-7467

Reviews and Comments

Social Worker in Dumfries, VA

John Frederick Gyampoh, Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 17299 Nugent Ln, Dumfries, VA 22026 Phone: 571-277-7346
Ms. Claudia N Goodall, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 3700 Fettler Park Dr, Dumfries, VA 22025 Phone: 703-441-7570
Beth Ann Herndon, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 3700 Fettler Park Dr, Dumfries, VA 22025 Phone: 703-441-7680
Tanyka Abbott, LCSW-C Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 4085 Middleton Loop Apt 203, Dumfries, VA 22025 Phone: 804-536-7232
Mrs. Amy Bartlett Taylor, LCSW, MSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 17606 Main St, Suite 204, Dumfries, VA 22026 Phone: 703-583-8616
Angela Catherine Gilbert, LMSW, LCSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 4282 Wiltshire Pl, Dumfries, VA 22025 Phone: 703-915-3189

Ebony Nicole Calloway, LICSW - Medicare Clinical Social Worker in Dumfries, VA