Mr Ray Jamaal Herndon, LCSW in Colorado Springs, CO - Medicare Clinical Social Worker Provider

Mr Ray Jamaal Herndon, LCSW is a medicare enrolled "Social Worker - Clinical" provider in Colorado Springs, Colorado. He graduated from healthcare school in 2020 and has 6 years of diverse experience with area of expertise as Clinical Social Worker. He is a member of the group practice Sondermind Provider Network Llc and his current practice location is 1400 E Boulder St, Colorado Springs, Colorado. You can reach out to his office (for appointments etc.) via phone at (719) 365-7505.

Mr Ray Jamaal Herndon is licensed to practice in Colorado (license number CSW.09928508) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1760611636.

Contact Information

	Mr Ray Jamaal Herndon, LCSW
	1400 E Boulder St, Colorado Springs, CO 80909-5533
	(719) 365-7505
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Mr Ray Jamaal Herndon
Gender	Male
Speciality	Clinical Social Worker
Experience	6 Years
Location	1400 E Boulder St, Colorado Springs, Colorado
Accepts Medicare Assignments	Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Mr Ray Jamaal Herndon graduated from medical school in 2020

NPI Data:

NPI Number: 1760611636
Provider Enumeration Date: 07/13/2009
Last Update Date: 12/28/2022

Medicare PECOS Information:

PECOS PAC ID: 2567847031
Enrollment ID: I20220920000586

Medical Identifiers

Medical identifiers for Mr Ray Jamaal Herndon such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1760611636	NPI	-	NPPES
7565A	Other	CA	OUTPATIENT MENTAL HEALTH

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
101YM0800X	Counselor - Mental Health	(* (Not Available))	Secondary
1041C0700X	Social Worker - Clinical	CSW.09928508 (Colorado)	Primary

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Sondermind Provider Network Llc	9537572490	874

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 Ray Jamaal Herndon allows following entities to bill medicare on his behalf.

Entity Name	Sondermind Provider Network Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1760854442 PECOS PAC ID: 9537572490 Enrollment ID: O20210113002826

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 Ray Jamaal Herndon 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 Ray Jamaal Herndon, LCSW Po Box 15555, Colorado Springs, CO 80935-5555 Ph: (909) 912-5351	Mr Ray Jamaal Herndon, LCSW 1400 E Boulder St, Colorado Springs, CO 80909-5533 Ph: (719) 365-7505

Mr Ray Jamaal Herndon, LCSW - Medicare Counselor in Colorado Springs, CO