Larae Roach, LISW-S, LICDC is a medicare enrolled "Social Worker - Clinical" provider in Columbus, Ohio. Her current practice location is
2323 Lake Club Dr, Columbus, Ohio. You can reach out to her office (for appointments etc.) via phone at
(380) 242-2900.
Larae Roach is licensed to practice in Ohio (license number I.2203881-SUPV) 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 1962914416.
Healthcare Provider's Profile
| Full Name | Larae Roach |
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| Gender | Female |
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| Speciality | Social Worker - Clinical |
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| Location | 2323 Lake Club Dr, Columbus, Ohio |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1962914416
- Provider Enumeration Date: 10/24/2017
- Last Update Date: 08/10/2026
Medicare PECOS Information:
- PECOS PAC ID: 6305372418
- Enrollment ID: I20241212003516
Medical Identifiers
Medical identifiers for Larae Roach such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1962914416 | NPI | - | NPPES |
| LCDC.131227-3 | Other | OH | LICENSURE |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | LICDC.161889 (Ohio) | Secondary |
| 1041C0700X | Social Worker - Clinical | I.2203881-SUPV (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. Larae Roach allows following entities to bill medicare on her behalf.
| Entity Name | Thrive Behavioral Health Center |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1174066096
PECOS PAC ID: 1153852199
Enrollment ID: O20241002000499 |
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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. Larae Roach 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 |
|---|
Larae Roach, LISW-S, LICDC
2323 Lake Club Dr,
Columbus, OH 43232-3101
Ph: Not Available | Larae Roach, LISW-S, LICDC
2323 Lake Club Dr,
Columbus, OH 43232-3101
Ph: (380) 242-2900 |
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