Chastidy Mariah Chacon, LPC is a medicare enrolled "Counselor - Professional" provider in La Jara, Colorado. Her current practice location is
322 Walnut Street, La Jara, Colorado. You can reach out to her office (for appointments etc.) via phone at
(719) 587-2288.
Chastidy Mariah Chacon is licensed to practice in Colorado (license number 18539) 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 1508581612.
Healthcare Provider's Profile
Full Name | Chastidy Mariah Chacon |
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Gender | Female |
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Speciality | Counselor - Professional |
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Location | 322 Walnut Street, La Jara, Colorado |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1508581612
- Provider Enumeration Date: 10/11/2022
- Last Update Date: 10/24/2022
Medicare PECOS Information:
- PECOS PAC ID: 7214387885
- Enrollment ID: I20231221003332
Medical Identifiers
Medical identifiers for Chastidy Mariah Chacon such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1508581612 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
101YP2500X | Counselor - Professional | 18539 (Colorado) | 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. Chastidy Mariah Chacon allows following entities to bill medicare on her behalf.
Entity Name | Valley-wide Health Systems, Inc. |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1790998953 PECOS PAC ID: 5991609067 Enrollment ID: O20031120000673 |
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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. Chastidy Mariah Chacon 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 |
Chastidy Mariah Chacon, LPC Po Box 514, La Jara, CO 81140-0514 Ph: (469) 810-2021 | Chastidy Mariah Chacon, LPC 322 Walnut Street, La Jara, CO 81140 Ph: (719) 587-2288 |
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