Jacob Averill, LCSW, LCAS, CCS is a medicare enrolled "Social Worker - Clinical" provider in Wilmington, North Carolina. His current practice location is
615 Shipyard Blvd, Wilmington, North Carolina. You can reach out to his office (for appointments etc.) via phone at
(910) 343-0145.
Jacob Averill is licensed to practice in North Carolina (license number C014123) 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 1659930618.
Healthcare Provider's Profile
| Full Name | Jacob Averill |
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| Gender | Male |
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| Speciality | Social Worker - Clinical |
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| Location | 615 Shipyard Blvd, Wilmington, North Carolina |
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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: 1659930618
- Provider Enumeration Date: 06/12/2019
- Last Update Date: 06/02/2025
Medicare PECOS Information:
- PECOS PAC ID: 8820483233
- Enrollment ID: I20220322002379
Medical Identifiers
Medical identifiers for Jacob Averill such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1659930618 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 25590 (North Carolina) | Secondary |
| 1041C0700X | Social Worker - Clinical | C014123 (North Carolina) | 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. Jacob Averill allows following entities to bill medicare on his behalf.
| Entity Name | Coastal Horizons Center, Inc. |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1922022607 PECOS PAC ID: 9739267964 Enrollment ID: O20080429000046 |
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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. Jacob Averill 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 |
Jacob Averill, LCSW, LCAS, CCS 615 Shipyard Blvd, Wilmington, NC 28412-6431 Ph: (910) 343-0145 | Jacob Averill, LCSW, LCAS, CCS 615 Shipyard Blvd, Wilmington, NC 28412-6431 Ph: (910) 343-0145 |
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