Amanda Jane Fortin, LCMHC in New London, NH - Medicare Counselor Provider

Amanda Jane Fortin, LCMHC is a medicare enrolled "Counselor - Mental Health" provider in New London, New Hampshire. Her current practice location is 35 Newport Rd, New London, New Hampshire. You can reach out to her office (for appointments etc.) via phone at (603) 865-1321.

Amanda Jane Fortin is licensed to practice in New Hampshire (license number 2643) 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 1962191809.

Contact Information

	Amanda Jane Fortin, LCMHC
	35 Newport Rd, New London, NH 03257-5413
	(603) 865-1321
	(603) 865-1327

Map and Direction

Healthcare Provider's Profile

Full Name	Amanda Jane Fortin
Gender	Female
Speciality	Counselor - Mental Health
Location	35 Newport Rd, New London, New Hampshire
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1962191809
Provider Enumeration Date: 05/05/2023
Last Update Date: 05/16/2023

Medicare PECOS Information:

PECOS PAC ID: 6709236045
Enrollment ID: I20231228001242

Medical Identifiers

Medical identifiers for Amanda Jane Fortin such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1962191809	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
101YM0800X	Counselor - Mental Health	2643 (New Hampshire)	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. Amanda Jane Fortin allows following entities to bill medicare on her behalf.

Entity Name	Counseling Associates Of New London Pllc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1205055365 PECOS PAC ID: 0042369910 Enrollment ID: O20090526000101

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. Amanda Jane Fortin 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
Amanda Jane Fortin, LCMHC 35 Newport Rd, New London, NH 03257-5413 Ph: (603) 865-1321	Amanda Jane Fortin, LCMHC 35 Newport Rd, New London, NH 03257-5413 Ph: (603) 865-1321

Reviews and Comments

Counselor in New London, NH

David L Pelletier, LMHC Counselor Medicare: Medicare Enrolled Practice Location: 35 Newport Rd, New London, NH 03257 Phone: 603-865-1321 Fax: 603-865-1327
James Bernard Esposito, LMHC Counselor Medicare: Medicare Enrolled Practice Location: 35 Newport Rd, New London, NH 03257 Phone: 603-865-1321 Fax: 603-865-1327
Aimee Y Tucker, MLADC Counselor Medicare: Not Enrolled in Medicare Practice Location: 35 Newport Rd, New London, NH 03257 Phone: 603-865-1327
Eva H Johnson, MLADC Counselor Medicare: Not Enrolled in Medicare Practice Location: 35 Newport Rd, New London, NH 03257 Phone: 603-865-1321 Fax: 603-865-1327
Kara Flynn Kidder, M.ED. Counselor Medicare: Not Enrolled in Medicare Practice Location: 370 Main Street, New London, NH 03257 Phone: 603-526-4230 Fax: 603-526-6261
Bruce Alexander Magoon, LCMHC Counselor Medicare: Not Enrolled in Medicare Practice Location: 370 Main St, New London, NH 03256 Phone: 603-526-4230
Ms. Kelley M Rambo, LSCSW, LPC, LCAC Counselor Medicare: Medicare Enrolled Practice Location: 35 Newport Rd, New London, NH 03257 Phone: 603-865-1321 Fax: 603-865-1327

Amanda Jane Fortin, LCMHC - Medicare Counselor in New London, NH