Kecia Marie Blakely, MSPSY, LMHC in South Bend, IN

Kecia Marie Blakely, MSPSY, LMHC is a medicare enrolled "Counselor - Mental Health" provider in South Bend, Indiana. Her current practice location is 52189 Scott St, South Bend, Indiana. You can reach out to her office (for appointments etc.) via phone at (574) 208-3359.

Kecia Marie Blakely is licensed to practice in Indiana (license number 39004492A) 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 1750602355.

Contact Information

	Kecia Marie Blakely, MSPSY, LMHC
	52189 Scott St, South Bend, IN 46637-2952
	(574) 208-3359
	(866) 812-9889

Map and Direction

Healthcare Provider's Profile

Full Name	Kecia Marie Blakely
Gender	Female
Speciality	Counselor - Mental Health
Location	52189 Scott St, South Bend, Indiana
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1750602355
Provider Enumeration Date: 06/17/2010
Last Update Date: 04/20/2023

Medicare PECOS Information:

PECOS PAC ID: 9739629973
Enrollment ID: I20240913002567

Medical Identifiers

Medical identifiers for Kecia Marie Blakely such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1750602355	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
101YM0800X	Counselor - Mental Health	39004492A (Indiana)	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. Kecia Marie Blakely allows following entities to bill medicare on her behalf.

Entity Name	Kecia Blakely Msp Lmhc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1598446395 PECOS PAC ID: 8820538069 Enrollment ID: O20240913002461

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. Kecia Marie Blakely 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
Kecia Marie Blakely, MSPSY, LMHC 1143 E Ireland Rd # 1003, South Bend, IN 46614-3446 Ph: (574) 208-3359	Kecia Marie Blakely, MSPSY, LMHC 52189 Scott St, South Bend, IN 46637-2952 Ph: (574) 208-3359

Reviews and Comments

Counselor in South Bend, IN

Breana S Bowsher, MSW Counselor Medicare: Not Enrolled in Medicare Practice Location: 415 E Madison St, South Bend, IN 46617 Phone: 574-283-1234 Fax: 574-283-1361
Mr. Donald Alden Cronk Iii, M.S., LMHC Counselor Medicare: Not Enrolled in Medicare Practice Location: 616 E Colfax Ave, South Bend, IN 46617 Phone: 574-277-7734 Fax: 574-277-7734
Lafo Robbins, MA Counselor Medicare: Not Enrolled in Medicare Practice Location: 403 E Madison St, South Bend, IN 46617 Phone: 574-283-1107 Fax: 574-283-1131
Clarice Shear, MA Counselor Medicare: Not Enrolled in Medicare Practice Location: 415 E Madison St, South Bend, IN 46617 Phone: 574-533-1234 Fax: 574-537-2652
Mrs. Carrie Anne Bianchini, LMHC Counselor Medicare: Not Enrolled in Medicare Practice Location: 415 E Madison St, South Bend, IN 46617 Phone: 574-533-1234 Fax: 574-537-2652
Karen Zeck, LMHC Counselor Medicare: Not Enrolled in Medicare Practice Location: 17195 Cleveland Rd, Samaritan Counseling Center, South Bend, IN 46635 Phone: 574-277-0274 Fax: 574-271-7202
Karen Tang, Counselor Medicare: Medicare Enrolled Practice Location: 415 E Madison St, South Bend, IN 46617 Phone: 574-533-1234 Fax: 574-537-2652

Kecia Marie Blakely, MSPSY, LMHC - Medicare Counselor in South Bend, IN