Lacey Rose Zawacki, is a medicare enrolled "Social Worker - Clinical" provider in Coon Rapids, Minnesota. Her current practice location is
9120 Springbrook Dr Nw, Coon Rapids, Minnesota. You can reach out to her office (for appointments etc.) via phone at
(612) 767-7222.
Lacey Rose Zawacki is licensed to practice in Minnesota (license number 29382) 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 1457029357.
Healthcare Provider's Profile
| Full Name | Lacey Rose Zawacki |
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| Gender | Female |
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| Speciality | Social Worker - Clinical |
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| Location | 9120 Springbrook Dr Nw, Coon Rapids, Minnesota |
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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: 1457029357
- Provider Enumeration Date: 09/03/2021
- Last Update Date: 09/29/2026
Medicare PECOS Information:
- PECOS PAC ID: 5395190276
- Enrollment ID: I20231012001662
Medical Identifiers
Medical identifiers for Lacey Rose Zawacki such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1457029357 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 101YM0800X | Counselor - Mental Health | (Minnesota) | Secondary |
| 1041C0700X | Social Worker - Clinical | 29382 (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. Lacey Rose Zawacki allows following entities to bill medicare on her behalf.
| Entity Name | Fraser Child and Family Center |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1609922194 PECOS PAC ID: 3971918772 Enrollment ID: O20210208002399 |
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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. Lacey Rose Zawacki 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 |
Lacey Rose Zawacki, 9120 Springbrook Dr Nw, Coon Rapids, MN 55433-5845 Ph: (612) 767-7222 | Lacey Rose Zawacki, 9120 Springbrook Dr Nw, Coon Rapids, MN 55433-5845 Ph: (612) 767-7222 |
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