Doug Fitzgerald, in Vicksburg, MS - Medicare Counselor Provider

Doug Fitzgerald, is a medicare enrolled "Counselor - Mental Health" provider in Vicksburg, Mississippi. His current practice location is 3444 Wisconsin Ave, Vicksburg, Mississippi. You can reach out to his office (for appointments etc.) via phone at (601) 638-0031.

Doug Fitzgerald is licensed to practice in * (Not Available) (license number ) 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 1417130600.

Contact Information

	Doug Fitzgerald,
	3444 Wisconsin Ave, Vicksburg, MS 39180-5331
	(601) 638-0031
	(601) 638-4950

Map and Direction

Healthcare Provider's Profile

Full Name	Doug Fitzgerald
Gender	Male
Speciality	Counselor - Mental Health
Location	3444 Wisconsin Ave, Vicksburg, Mississippi
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1417130600
Provider Enumeration Date: 12/11/2007
Last Update Date: 12/11/2007

Medicare PECOS Information:

PECOS PAC ID: 8527591817
Enrollment ID: I20241024003158

Medical Identifiers

Medical identifiers for Doug Fitzgerald such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1417130600	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
101YM0800X	Counselor - Mental Health	(* (Not Available))	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. Doug Fitzgerald allows following entities to bill medicare on his behalf.

Entity Name	Positive Pathways, Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1801335492 PECOS PAC ID: 0648678425 Enrollment ID: O20211021000305

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. Doug Fitzgerald 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
Doug Fitzgerald, 3444 Wisconsin Ave, Vicksburg, MS 39180-5331 Ph: (601) 638-0031	Doug Fitzgerald, 3444 Wisconsin Ave, Vicksburg, MS 39180-5331 Ph: (601) 638-0031

Reviews and Comments

Counselor in Vicksburg, MS

Kaila Virgil, Counselor Medicare: Not Enrolled in Medicare Practice Location: 3334 Wisconsin Ave., Vicksburg, MS 39180 Phone: 601-638-0031
Tiffany Smith, Counselor Medicare: Not Enrolled in Medicare Practice Location: 3444 Wisconsin Ave, Vicksburg, MS 39180 Phone: 601-638-0031 Fax: 601-638-4950
Felicia Wilson, PCMHT Counselor Medicare: Not Enrolled in Medicare Practice Location: 3444 Wisconsin Ave, Vicksburg, MS 39180 Phone: 601-638-0031 Fax: 601-638-4950
Heather Potts, Counselor Medicare: Not Enrolled in Medicare Practice Location: 3444 Wisconsin Ave, Vicksburg, MS 39180 Phone: 601-638-0031
Rosalyn Glascoe, Counselor Medicare: Not Enrolled in Medicare Practice Location: 3444 Wisconsin Ave, Vicksburg, MS 39180 Phone: 601-638-0031
Ann Nelson, LSW Counselor Medicare: Not Enrolled in Medicare Practice Location: 3444 Wisconsin Ave, Vicksburg, MS 39180 Phone: 601-638-0031 Fax: 601-638-4950
Mr. Walter Lee Frazier, MCP, LPC, NCC Counselor Medicare: Medicare Enrolled Practice Location: 1414 Cherry St, Vicksburg, MS 39180 Phone: 601-636-5703 Fax: 601-636-5739

Doug Fitzgerald, - Medicare Counselor in Vicksburg, MS