Shandra Thea Rotenberry, LICSW in Liberty Lake, WA - Medicare Clinical Social Worker Provider

Shandra Thea Rotenberry, LICSW is a medicare enrolled "Social Worker - Clinical" provider in Liberty Lake, Washington. She graduated from medical school in 2013 and has 13 years of diverse experience with area of expertise as Clinical Social Worker. She is a member of the group practice Mindful Therapy Group Pc and her current practice location is 23505 E Appleway Ave Ste 200-540, Liberty Lake, Washington. You can reach out to her office (for appointments etc.) via phone at (253) 465-2236.

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

Contact Information

	Shandra Thea Rotenberry, LICSW
	23505 E Appleway Ave Ste 200-540, Liberty Lake, WA 99019-6065
	(253) 465-2236
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Shandra Thea Rotenberry
Gender	Female
Speciality	Clinical Social Worker
Experience	13 Years
Location	23505 E Appleway Ave Ste 200-540, Liberty Lake, Washington
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:

Shandra Thea Rotenberry graduated from medical school in 2013

NPI Data:

NPI Number: 1053884528
Provider Enumeration Date: 01/08/2019
Last Update Date: 05/03/2026

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

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Mindful Therapy Group Pc	4981872561	630

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 1484 Marion County 4003, Yellville, AR 72687-9343 Ph: (714) 356-8077	Shandra Thea Rotenberry, LICSW 23505 E Appleway Ave Ste 200-540, Liberty Lake, WA 99019-6065 Ph: (253) 465-2236

Reviews and Comments

Social Worker in Liberty Lake, WA

Ms. Eleanor Martha Limmer, M.S.W. Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1227 S Liberty Dr, Liberty Lake, WA 99019 Phone: 509-536-9730 Fax: 509-535-3981
Rose Lydia Ayars, LICSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 22875 E Edgewater Ln, Liberty Lake, WA 99019 Phone: 720-557-7111
Ms. Jeannie Dalton, LCSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 23505 E Appleway Ave Ste 200 #200-1026, Liberty Lake, WA 99019 Phone: 509-253-7834
Raymond R Lester, LICSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 2110 N Molter Rd, Liberty Lake, WA 99019 Phone: 509-599-5794
Svetlana Cervantes, MSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1790 N Willamette Rd, Liberty Lake, WA 99016 Phone: 509-216-2454

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