Grace Connolly, LSW CDCA is a medicare enrolled "Social Worker" provider in Willoughby, Ohio. Her current practice location is
38882 Mentor Ave, Willoughby, Ohio. You can reach out to her office (for appointments etc.) via phone at
(440) 578-8200.
Grace Connolly is licensed to practice in * (Not Available) (license number ) 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 1477264620.
Healthcare Provider's Profile
| Full Name | Grace Connolly |
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| Gender | Female |
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| Speciality | Social Worker |
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| Location | 38882 Mentor Ave, Willoughby, Ohio |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1477264620
- Provider Enumeration Date: 12/08/2022
- Last Update Date: 03/03/2025
Medicare PECOS Information:
- PECOS PAC ID: 7911420625
- Enrollment ID: I20250402002808
Medical Identifiers
Medical identifiers for Grace Connolly such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1477264620 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101Y00000X | Counselor | S.1802996 (Ohio) | Secondary |
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Secondary |
| 104100000X | Social Worker | (* (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. Grace Connolly allows following entities to bill medicare on her behalf.
| Entity Name | Signature Health, Inc. |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1679767289
PECOS PAC ID: 8628970985
Enrollment ID: O20040126000762 |
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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. Grace Connolly 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 |
|---|
Grace Connolly, LSW CDCA
7232 Justin Way,
Mentor, OH 44060-4881
Ph: (440) 578-8200 | Grace Connolly, LSW CDCA
38882 Mentor Ave,
Willoughby, OH 44094-7875
Ph: (440) 578-8200 |
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