Kirby Kaczor, LPCC in White Bear Lake, MN - Medicare Counselor Provider

Kirby Kaczor, LPCC is a medicare enrolled "Counselor" provider in White Bear Lake, Minnesota. His current practice location is 2025 4th St Ste 100, White Bear Lake, Minnesota. You can reach out to his office (for appointments etc.) via phone at (651) 212-4920.

Kirby Kaczor is licensed to practice in Minnesota (license number 4263) 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 1003679234.

Contact Information

	Kirby Kaczor, LPCC
	2025 4th St Ste 100, White Bear Lake, MN 55110-2875
	(651) 212-4920
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Kirby Kaczor
Gender	Male
Speciality	Counselor
Location	2025 4th St Ste 100, White Bear Lake, Minnesota
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1003679234
Provider Enumeration Date: 01/31/2024
Last Update Date: 01/31/2024

Medicare PECOS Information:

PECOS PAC ID: 7911341102
Enrollment ID: I20240215001691

Medical Identifiers

Medical identifiers for Kirby Kaczor such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1003679234	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
101Y00000X	Counselor	4263 (Minnesota)	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. Kirby Kaczor allows following entities to bill medicare on his behalf.

Entity Name	Wild Tree Psychotherapy Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1528451408 PECOS PAC ID: 8426408881 Enrollment ID: O20231227001431

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. Kirby Kaczor 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
Kirby Kaczor, LPCC 2025 4th St Ste 100, White Bear Lake, MN 55110-2875 Ph: (651) 212-4920	Kirby Kaczor, LPCC 2025 4th St Ste 100, White Bear Lake, MN 55110-2875 Ph: (651) 212-4920

Reviews and Comments

Counselor in White Bear Lake, MN

Mrs. Tabitha Soderstrom, MS Counselor Medicare: Not Enrolled in Medicare Practice Location: 3596 Linden Ave, White Bear Lake, MN 55110 Phone: 507-215-2459
Mr. Andrew Clark Hoistad, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1245 Gun Club Rd, White Bear Lake, MN 55110 Phone: 612-644-4887
Chester Mulholland, LPCC Counselor Medicare: Medicare Enrolled Practice Location: 3596 Linden Ave, White Bear Lake, MN 55110 Phone: 651-243-2484
Julie Blaske, MA LADC LMFT Counselor Medicare: Medicare Enrolled Practice Location: 1310 Hwy 96 E, Suite 200, White Bear Lake, MN 55110 Phone: 612-241-6004
Anna Schulze, Counselor Medicare: Not Enrolled in Medicare Practice Location: 4756 Banning Ave Ste 210, White Bear Lake, MN 55110 Phone: 612-454-1656
Stacey Ann Feig, LPP Counselor Medicare: Not Enrolled in Medicare Practice Location: 3830 Prairie Rd, White Bear Lake, MN 55110 Phone: 651-373-1726

Kirby Kaczor, LPCC - Medicare Counselor in White Bear Lake, MN