Mr Gontran S Archer Jr, MA, LCPC in Upper Marlboro, MD

Mr Gontran S Archer Jr, MA, LCPC is a medicare enrolled "Counselor - Mental Health" provider in Upper Marlboro, Maryland. His current practice location is 509 Dennis Magruder Dr, Upper Marlboro, Maryland. You can reach out to his office (for appointments etc.) via phone at (585) 305-1465.

Mr Gontran S Archer Jr is licensed to practice in Maryland (license number LC13937) 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 1568144400.

Contact Information

	Mr Gontran S Archer Jr, MA, LCPC
	509 Dennis Magruder Dr, Upper Marlboro, MD 20774-2110
	(585) 305-1465
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Mr Gontran S Archer Jr
Gender	Male
Speciality	Counselor - Mental Health
Location	509 Dennis Magruder Dr, Upper Marlboro, Maryland
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1568144400
Provider Enumeration Date: 08/01/2023
Last Update Date: 04/28/2025

Medicare PECOS Information:

PECOS PAC ID: 5193162691
Enrollment ID: I20240320000224

Medical Identifiers

Medical identifiers for Mr Gontran S Archer Jr such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1568144400	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
101YP2500X	Counselor - Professional	LC13937 (Maryland)	Secondary
101YM0800X	Counselor - Mental Health	LC13937 (Maryland)	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. Mr Gontran S Archer Jr allows following entities to bill medicare on his behalf.

Entity Name	Professional Services Of Holy Cross
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1487692828 PECOS PAC ID: 3779516992 Enrollment ID: O20050916000745

Entity Name	Premier Health Care Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1285017822 PECOS PAC ID: 7618285842 Enrollment ID: O20151008000494

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. Mr Gontran S Archer Jr 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
Mr Gontran S Archer Jr, MA, LCPC 509 Dennis Magruder Dr, Upper Marlboro, MD 20774-2110 Ph: (585) 305-1464	Mr Gontran S Archer Jr, MA, LCPC 509 Dennis Magruder Dr, Upper Marlboro, MD 20774-2110 Ph: (585) 305-1465

Reviews and Comments

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Mr Gontran S Archer Jr, MA, LCPC - Medicare Counselor in Upper Marlboro, MD