Shandra Thea Rotenberry, LICSW in Spanaway, WA - Medicare Social Worker Provider

Shandra Thea Rotenberry, LICSW is a medicare enrolled "Social Worker - Clinical" provider in Spanaway, Washington. Her current practice location is 18020 15th Ave E, Spanaway, Washington. You can reach out to her office (for appointments etc.) via phone at (714) 356-8077.

Shandra Thea Rotenberry is licensed to practice in Washington (license number LW60854195) 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 1053884528.

Contact Information

	Shandra Thea Rotenberry, LICSW
	18020 15th Ave E, Spanaway, WA 98387-1936
	(714) 356-8077
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Shandra Thea Rotenberry
Gender	Female
Speciality	Social Worker - Clinical
Location	18020 15th Ave E, Spanaway, Washington
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1053884528
Provider Enumeration Date: 01/08/2019
Last Update Date: 03/26/2025

Medicare PECOS Information:

PECOS PAC ID: 6901339449
Enrollment ID: I20241023000999

Medical Identifiers

Medical identifiers for Shandra Thea Rotenberry such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1053884528	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
1041C0700X	Social Worker - Clinical	LW60854195 (Washington)	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. Shandra Thea Rotenberry allows following entities to bill medicare on her behalf.

Entity Name	Mindful Therapy Group Pc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1316238678 PECOS PAC ID: 4981872561 Enrollment ID: O20110726000730

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. Shandra Thea Rotenberry 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
Shandra Thea Rotenberry, LICSW 18020 15th Ave E, Spanaway, WA 98387-1936 Ph: (714) 356-8077	Shandra Thea Rotenberry, LICSW 18020 15th Ave E, Spanaway, WA 98387-1936 Ph: (714) 356-8077

Reviews and Comments

Social Worker in Spanaway, WA

Derrick D'abreau, LICSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: Po Box 4092, Spanaway, WA 98387 Phone: 425-272-5986 Fax: 253-352-4036
Mrs. Akimma Wright-d'abreau, MSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1415 196th St E, Spanaway, WA 98387 Phone: 253-985-5732
Mr. Chad Patrick Cummings, MSW, LICSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 2114 198th St E, Spanaway, WA 98387 Phone: 253-228-5891
Victoria Anne Purnell, MSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 201 160th St S, Spanaway, WA 98387 Phone: 253-219-1217
Carianne Sellers, LICSWA Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 20505 85th Avenue Ct E, Spanaway, WA 98387 Phone: 253-468-6456
Dione Colette Savage, MSW, LICSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1615 185th Street Ct E, Spanaway, WA 98387 Phone: 253-988-1576

Shandra Thea Rotenberry, LICSW - Medicare Clinical Social Worker in Spanaway, WA