Tasha Lynn Wisdom, LCSW is a medicare enrolled "Social Worker - Clinical" provider in Ellington, Missouri. Her current practice location is
315 E Walnut St, Ellington, Missouri. You can reach out to her office (for appointments etc.) via phone at
(573) 663-2644.
Tasha Lynn Wisdom is licensed to practice in Missouri (license number 2014018308) 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 1730450156.
Healthcare Provider's Profile
| Full Name | Tasha Lynn Wisdom |
|---|
| Gender | Female |
|---|
| Speciality | Social Worker - Clinical |
|---|
| Location | 315 E Walnut St, Ellington, Missouri |
|---|
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1730450156
- Provider Enumeration Date: 01/17/2012
- Last Update Date: 10/30/2023
Medicare PECOS Information:
- PECOS PAC ID: 6608193651
- Enrollment ID: I20150331002659
Medical Identifiers
Medical identifiers for Tasha Lynn Wisdom such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1730450156 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 1041C0700X | Social Worker - Clinical | 2014018308 (Missouri) | 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. Tasha Lynn Wisdom allows following entities to bill medicare on her behalf.
| Entity Name | Family Counseling Center Inc |
|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
|---|
| Entity Identifiers | NPI Number: 1669477550 PECOS PAC ID: 2163410481 Enrollment ID: O20040609001127 |
|---|
| Entity Name | Iron County Hospital District |
|---|
| Entity Type | Part A Provider - Critical Access Hospital |
|---|
| Entity Identifiers | NPI Number: 1477648178 PECOS PAC ID: 0941207526 Enrollment ID: O20061104000718 |
|---|
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. Tasha Lynn Wisdom 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 |
Tasha Lynn Wisdom, LCSW 315 E Walnut St, Ellington, MO 63638-7943 Ph: (573) 663-2644 | Tasha Lynn Wisdom, LCSW 315 E Walnut St, Ellington, MO 63638 Ph: (573) 663-2644 |
Reviews and Comments