Holly Selepouchin, in East Stroudsburg, PA - Medicare Social Worker Provider

Holly Selepouchin, is a medicare enrolled "Social Worker - Clinical" provider in East Stroudsburg, Pennsylvania. Her current practice location is 527 Hallowood Dr, East Stroudsburg, Pennsylvania. You can reach out to her office (for appointments etc.) via phone at (973) 670-6893.

Holly Selepouchin is licensed to practice in New Jersey (license number 44SC058533900) 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 1932757754.

Contact Information

	Holly Selepouchin,
	527 Hallowood Dr, East Stroudsburg, PA 18302-7728
	(973) 670-6893
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Holly Selepouchin
Gender	Female
Speciality	Social Worker - Clinical
Location	527 Hallowood Dr, East Stroudsburg, Pennsylvania
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1932757754
Provider Enumeration Date: 08/27/2019
Last Update Date: 03/04/2024

Medicare PECOS Information:

PECOS PAC ID: 3274053640
Enrollment ID: I20250228001502

Medical Identifiers

Medical identifiers for Holly Selepouchin such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1932757754	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
1041C0700X	Social Worker - Clinical	44SC058533900 (New Jersey)	Primary
1041C0700X	Social Worker - Clinical	(* (Not Available))	Secondary

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. Holly Selepouchin allows following entities to bill medicare on her behalf.

Entity Name	Forge Medical Group, Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1962175026 PECOS PAC ID: 5597163949 Enrollment ID: O20211015000010

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. Holly Selepouchin 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
Holly Selepouchin, 527 Hallowood Dr, East Stroudsburg, PA 18302-7728 Ph: () -	Holly Selepouchin, 527 Hallowood Dr, East Stroudsburg, PA 18302-7728 Ph: (973) 670-6893

Reviews and Comments

Social Worker in East Stroudsburg, PA

Leah Rivera, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 327 Park Ln, East Stroudsburg, PA 18301 Phone: 570-460-3299
Prunella Harris, LCSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 529 Seven Bridge Rd, Suite 205, East Stroudsburg, PA 18301 Phone: 570-807-0267
Ms. Norma June Swint, L.C.S.W Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: Rr 5 Box 5289, East Stroudsburg, PA 18301 Phone: 570-223-0826
Mrs. Pamler Ruth Pope-plummer, LCSW-R Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 312 Hosta Lane, East Stroudsburg, PA 18301 Phone: 347-277-1626
Jennifer Elizabeth Rodriguez, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 95 Crystal St, East Stroudsburg, PA 18301 Phone: 321-222-7532

Holly Selepouchin, - Medicare Clinical Social Worker in East Stroudsburg, PA