Anthony Imagie-douglas, LICDC in Circleville, OH

Anthony Imagie-douglas, LICDC is a medicare enrolled "Counselor - Addiction (substance Use Disorder)" provider in Circleville, Ohio. His current practice location is 1875 Stoneridge Dr, Circleville, Ohio. You can reach out to his office (for appointments etc.) via phone at (740) 500-1391.

Anthony Imagie-douglas is licensed to practice in Ohio (license number LICDC.111022) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1578146635.

Contact Information

	Anthony Imagie-douglas, LICDC
	1875 Stoneridge Dr, Circleville, OH 43113-8956
	(740) 500-1391
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Anthony Imagie-douglas
Gender	Male
Speciality	Counselor - Addiction (substance Use Disorder)
Location	1875 Stoneridge Dr, Circleville, Ohio
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1578146635
Provider Enumeration Date: 05/05/2021
Last Update Date: 05/05/2021

Medicare PECOS Information:

PECOS PAC ID: 3375061377
Enrollment ID: I20250514000158

Medical Identifiers

Medical identifiers for Anthony Imagie-douglas such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1578146635	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
101YA0400X	Counselor - Addiction (substance Use Disorder)	LICDC.111022 (Ohio)	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. Anthony Imagie-douglas allows following entities to bill medicare on his behalf.

Entity Name	Full Circle Recovery Of Circleville
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1861137408 PECOS PAC ID: 2264953249 Enrollment ID: O20250306001333

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. Anthony Imagie-douglas 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
Anthony Imagie-douglas, LICDC 2065 Stoneridge Dr, Circleville, OH 43113-8956 Ph: (740) 500-1391	Anthony Imagie-douglas, LICDC 1875 Stoneridge Dr, Circleville, OH 43113-8956 Ph: (740) 500-1391

Reviews and Comments

Counselor in Circleville, OH

Judson Scott Karshner, Counselor Medicare: Not Enrolled in Medicare Practice Location: 327 E Mill St, Circleville, OH 43113 Phone: 740-500-1402
Sheena Artrip, CDCA Counselor Medicare: Not Enrolled in Medicare Practice Location: 110 Highland Ave, Circleville, OH 43113 Phone: 740-477-1745
Sujata Baral, Counselor Medicare: Not Enrolled in Medicare Practice Location: 145 Morris Rd, Circleville, OH 43113 Phone: 740-474-8874
Cassandra Nicole Patterson, Counselor Medicare: Not Enrolled in Medicare Practice Location: 327 E Mill St, Circleville, OH 43113 Phone: 740-500-1402
Matthew David Coy, Counselor Medicare: Not Enrolled in Medicare Practice Location: 145 Morris Rd, Circleville, OH 43113 Phone: 740-474-8874
Caitlin Huston, CDCA Counselor Medicare: Not Enrolled in Medicare Practice Location: 2065 Stoneridge Dr, Circleville, OH 43113 Phone: 740-500-1391
Mallorie Dennelle Garrett, CDCA Counselor Medicare: Not Enrolled in Medicare Practice Location: 2065 Stoneridge Dr, Circleville, OH 43113 Phone: 740-500-1391

Anthony Imagie-douglas, LICDC - Medicare Counselor in Circleville, OH