Latesah Rosha Burks, LCSW in Madison, MS - Medicare Social Worker Provider

Latesah Rosha Burks, LCSW is a medicare enrolled "Social Worker - Clinical" provider in Madison, Mississippi. Her current practice location is 105 Executive Dr, Madison, Mississippi. You can reach out to her office (for appointments etc.) via phone at (601) 258-0818.

Latesah Rosha Burks is licensed to practice in Mississippi (license number C11093) 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 1700620960.

Contact Information

	Latesah Rosha Burks, LCSW
	105 Executive Dr, Madison, MS 39110-8496
	(601) 258-0818
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Latesah Rosha Burks
Gender	Female
Speciality	Social Worker - Clinical
Location	105 Executive Dr, Madison, Mississippi
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1700620960
Provider Enumeration Date: 06/22/2024
Last Update Date: 06/22/2024

Medicare PECOS Information:

PECOS PAC ID: 5092246041
Enrollment ID: I20241002001173

Medical Identifiers

Medical identifiers for Latesah Rosha Burks such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1700620960	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
1041C0700X	Social Worker - Clinical	C11093 (Mississippi)	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. Latesah Rosha Burks allows following entities to bill medicare on her behalf.

Entity Name	Family Coaching Clinic
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1730869892 PECOS PAC ID: 9638618416 Enrollment ID: O20240823002883

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. Latesah Rosha Burks 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
Latesah Rosha Burks, LCSW 205 Travis Cv, Flora, MS 39071-8908 Ph: (601) 258-0818	Latesah Rosha Burks, LCSW 105 Executive Dr, Madison, MS 39110-8496 Ph: (601) 258-0818

Reviews and Comments

Social Worker in Madison, MS

Ms. Brenda B Donald, LCSW, BCD Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 133 Executive Dr, Suite B, Madison, MS 39110 Phone: 601-898-7778
Pamela D Stalder, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 254 Ingleside Dr, Madison, MS 39110 Phone: 601-695-1919 Fax: 601-420-5299
Kristin Wallace, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 940 Ebenezer Blvd, Madison, MS 39110 Phone: 601-790-0583
Cheri L Nyegaard Holbrook, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 254 Ingleside Dr, Madison, MS 39110 Phone: 601-695-1919 Fax: 601-420-5299
Fred Rickman, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 254 Ingleside Dr, Madison, MS 39110 Phone: 601-695-1919 Fax: 601-420-5299
Melinda Edwards, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 254 Ingleside Dr, Madison, MS 39110 Phone: 601-695-1919 Fax: 601-420-5299
Melanie L Moreau, LCSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 254 Ingleside Dr, Madison, MS 39110 Phone: 601-695-1919 Fax: 601-420-5299

Latesah Rosha Burks, LCSW - Medicare Clinical Social Worker in Madison, MS