Jalisa Smith-jordan, LCSW in Peoria, IL - Medicare Social Worker Provider

Jalisa Smith-jordan, LCSW is a medicare enrolled "Social Worker - Clinical" provider in Peoria, Illinois. Her current practice location is 1200 Hamilton Blvd, Peoria, Illinois. You can reach out to her office (for appointments etc.) via phone at (309) 671-8040.

Jalisa Smith-jordan is licensed to practice in Illinois (license number 149024181) 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 1659015451.

Contact Information

	Jalisa Smith-jordan, LCSW
	1200 Hamilton Blvd, Peoria, IL 61606-1525
	(309) 671-8040
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Jalisa Smith-jordan
Gender	Female
Speciality	Social Worker - Clinical
Location	1200 Hamilton Blvd, Peoria, Illinois
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1659015451
Provider Enumeration Date: 04/27/2022
Last Update Date: 04/27/2022

Medicare PECOS Information:

PECOS PAC ID: 2466830740
Enrollment ID: I20220526002342

Medical Identifiers

Medical identifiers for Jalisa Smith-jordan such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1659015451	NPI	-	NPPES
149024181	Other	IL	LICENSE

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
1041C0700X	Social Worker - Clinical	149024181 (Illinois)	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. Jalisa Smith-jordan allows following entities to bill medicare on her behalf.

Entity Name	Tazwood Mental Health Center Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1083671127 PECOS PAC ID: 1850291741 Enrollment ID: O20040108000963

Entity Name	Human Service Center
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1881630689 PECOS PAC ID: 6901896968 Enrollment ID: O20040513000449

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. Jalisa Smith-jordan 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
Jalisa Smith-jordan, LCSW 1200 Hamilton Blvd, Peoria, IL 61606-1525 Ph: () -	Jalisa Smith-jordan, LCSW 1200 Hamilton Blvd, Peoria, IL 61606-1525 Ph: (309) 671-8040

Reviews and Comments

Social Worker in Peoria, IL

Ginger Renee Hughes Garner, LCSW, CADC Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 7717 N Orange Prairie Rd, Peoria, IL 61615 Phone: 309-267-2289
Jaimie M Peterson, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 2265 W Altorfer Dr, Peoria, IL 61615 Phone: 309-683-7700 Fax: 309-683-7752
Shannon Dolan, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 7717 N Orange Prairie Rd, Peoria, IL 61615 Phone: 309-589-6800
Ms. Shannon Amber Wilson, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 3535 N California Ave, Suite F, Peoria, IL 61603 Phone: 309-686-2153 Fax: 888-371-6976
Eddie K Wong, MSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 600 Fayette St, Peoria, IL 61603 Phone: 309-671-8005 Fax: 309-671-8021
Catherine J Kilbourn, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 900 Main St, Suite 580, Peoria, IL 61602 Phone: 309-637-4266 Fax: 309-637-9836
Mrs. Sylvia Ana Murphy, LCSW, MA Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 2000 W Pioneer Pkwy, Suite 3, Peoria, IL 61615 Phone: 309-402-0666 Fax: 309-402-0563

Jalisa Smith-jordan, LCSW - Medicare Clinical Social Worker in Peoria, IL