Emma Shackleton, LCPC in Rockford, IL - Medicare Counselor Provider

Emma Shackleton, LCPC is a medicare enrolled "Counselor - Professional" provider in Rockford, Illinois. Her current practice location is 695 N Perryville Rd Ste 4, Rockford, Illinois. You can reach out to her office (for appointments etc.) via phone at (779) 368-0060.

Emma Shackleton is licensed to practice in Illinois (license number 180.014466) 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 1396221669.

Contact Information

	Emma Shackleton, LCPC
	695 N Perryville Rd Ste 4, Rockford, IL 61107-6225
	(779) 368-0060
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Emma Shackleton
Gender	Female
Speciality	Counselor - Professional
Location	695 N Perryville Rd Ste 4, Rockford, Illinois
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1396221669
Provider Enumeration Date: 07/19/2018
Last Update Date: 05/01/2023

Medicare PECOS Information:

PECOS PAC ID: 0941721781
Enrollment ID: I20250310000574

Medical Identifiers

Medical identifiers for Emma Shackleton such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1396221669	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
101YP2500X	Counselor - Professional	180.014466 (Illinois)	Primary
101Y00000X	Counselor	(* (Not Available))	Secondary

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. Emma Shackleton allows following entities to bill medicare on her behalf.

Entity Name	Enlightened Ways Therapy, Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1073250437 PECOS PAC ID: 9830560747 Enrollment ID: O20230131002615

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. Emma Shackleton 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
Emma Shackleton, LCPC 695 N Perryville Rd Ste 4, Rockford, IL 61107-6225 Ph: () -	Emma Shackleton, LCPC 695 N Perryville Rd Ste 4, Rockford, IL 61107-6225 Ph: (779) 368-0060

Reviews and Comments

Counselor in Rockford, IL

Stephanie Yates, LCPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 6072 Brynwood Dr Ste 107, Rockford, IL 61114 Phone: 815-846-0684
Logan John Chapman-neal, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1601 University Dr, Rockford, IL 61107 Phone: 815-391-1000
Charlene J Donahoe, MS, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 4869 Linden Rd Apt 221, Rockford, IL 61109 Phone: 815-980-8621
Holly Brun, Counselor Medicare: Medicare Enrolled Practice Location: 8616 Northern Ave, Rockford, IL 61107 Phone: 815-332-8003
Jeremy Adon Mcintosh, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1601 University Dr, Rockford, IL 61107 Phone: 815-391-1000
Angie Tompkins, LCPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 6066 Strathmoor Dr Ste 2, Rockford, IL 61107 Phone: 815-324-3979
Ms. Eileen H Mccarten, MS, LCPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 3600 E State St Ste 316, Rockford, IL 61108 Phone: 815-877-7228 Fax: 815-877-8172

Emma Shackleton, LCPC - Medicare Counselor in Rockford, IL