Ms Elissa Forman, LICSW in Florence, MA - Medicare Clinical Social Worker Provider

Ms Elissa Forman, LICSW is a medicare enrolled "Social Worker - Clinical" provider in Florence, Massachusetts. She graduated from medical school in 1996 and has 29 years of diverse experience with area of expertise as Clinical Social Worker. She is a member of the group practice Valley Medical Group Pc and her current practice location is 70 Main St, Florence, Massachusetts. You can reach out to her office (for appointments etc.) via phone at (413) 586-8400.

Ms Elissa Forman is licensed to practice in Massachusetts (license number 1031672) 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 1578532438.

Contact Information

	Ms Elissa Forman, LICSW
	70 Main St, Florence, MA 01062-1466
	(413) 586-8400
	(866) 644-0872

Map and Direction

Healthcare Provider's Profile

Full Name	Ms Elissa Forman
Gender	Female
Speciality	Clinical Social Worker
Experience	29 Years
Location	70 Main St, Florence, Massachusetts
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:

Ms Elissa Forman graduated from medical school in 1996

NPI Data:

NPI Number: 1578532438
Provider Enumeration Date: 03/14/2006
Last Update Date: 12/11/2023

Medicare PECOS Information:

PECOS PAC ID: 6406756071
Enrollment ID: I20040110000058

Medical Identifiers

Medical identifiers for Ms Elissa Forman such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1578532438	NPI	-	NPPES
3172516	Other	MA	CIGNA BEHAVIORAL HEALTH
33214	Other	MA	HEALTH NEW ENGLAND
593372000	Other	MA	MAGELLAN BEHAVIORAL HEALT
102517	Other	MA	FALLON
P07575	Other	MA	BLUE CROSS BLUE SHIELD
468597	Other	MA	TUFTS HEALTH PLAN

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
1041C0700X	Social Worker - Clinical	1031672 (Massachusetts)	Primary

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Valley Medical Group Pc	2365348851	107

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. Ms Elissa Forman allows following entities to bill medicare on her behalf.

Entity Name	Valley Medical Group Pc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1912924705 PECOS PAC ID: 2365348851 Enrollment ID: O20031208000239

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. Ms Elissa Forman 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
Ms Elissa Forman, LICSW 70 Main St, Florence, MA 01062 Ph: (413) 586-8400	Ms Elissa Forman, LICSW 70 Main St, Florence, MA 01062-1466 Ph: (413) 586-8400

Reviews and Comments

Social Worker in Florence, MA

Miss Julie Beth Rosenshein, LICSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 3 Bratton Ct, Florence, MA 01062 Phone: 413-262-1137
Alison Brassard L'heureux, LICSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 29 N Main St, Florence, MA 01062 Phone: 413-586-5382 Fax: 413-582-1832
Mary Lutkus, LICSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 60 Maple St, Florence, MA 01062 Phone: 413-535-6521
Anne E Roughton, LICSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 60 Maple St, Ste 2b, Florence, MA 01062 Phone: 413-387-7767
Mr. Robert P Hincks, LICSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 70 Main St, Northampton Health Center, Florence, MA 01062 Phone: 413-586-8400 Fax: 413-585-5491
Emma Reilly, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 29 N Main St, Florence, MA 01062 Phone: 413-586-5555
Miriam Greenbaum Solomon, LCSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 146 Maplewood Ter, Florence, MA 01062 Phone: 617-230-5983

Ms Elissa Forman, LICSW - Medicare Clinical Social Worker in Florence, MA