Kira Sue Rodriguez, LISW, LCDC III is a medicare enrolled "Counselor - Mental Health" provider in Gibsonburg, Ohio. Her current practice location is
400 W Madison St, Gibsonburg, Ohio. You can reach out to her office (for appointments etc.) via phone at
(567) 201-6450.
Kira Sue Rodriguez is licensed to practice in Ohio (license number I.1901397) 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 1689276263.
Healthcare Provider's Profile
| Full Name | Kira Sue Rodriguez |
|---|
| Gender | Female |
|---|
| Speciality | Counselor - Mental Health |
|---|
| Location | 400 W Madison St, Gibsonburg, Ohio |
|---|
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
|---|
NPI Data:
- NPI Number: 1689276263
- Provider Enumeration Date: 11/10/2020
- Last Update Date: 11/10/2020
Medicare PECOS Information:
- PECOS PAC ID: 4880051820
- Enrollment ID: I20230606001954
Medical Identifiers
Medical identifiers for Kira Sue Rodriguez such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1689276263 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YM0800X | Counselor - Mental Health | I.1901397 (Ohio) | 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. Kira Sue Rodriguez allows following entities to bill medicare on her behalf.
| Entity Name | 360team Counseling Llc |
|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
|---|
| Entity Identifiers | NPI Number: 1881277242
PECOS PAC ID: 5991109662
Enrollment ID: O20210803003751 |
|---|
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. Kira Sue Rodriguez 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 |
|---|
Kira Sue Rodriguez, LISW, LCDC III
400 W Madison St,
Gibsonburg, OH 43431-1221
Ph: (567) 201-6450 | Kira Sue Rodriguez, LISW, LCDC III
400 W Madison St,
Gibsonburg, OH 43431-1221
Ph: (567) 201-6450 |
Reviews and Comments