Mrs Jacqueline Ejim, LCPC in Baltimore, MD - Medicare Counselor Provider

Mrs Jacqueline Ejim, LCPC is a medicare enrolled "Counselor - Professional" provider in Baltimore, Maryland. Her current practice location is 1040 Park Ave Ste 200, Baltimore, Maryland. You can reach out to her office (for appointments etc.) via phone at (443) 738-0300.

Mrs Jacqueline Ejim is licensed to practice in Maryland (license number LC7848) 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 1861920282.

Contact Information

	Mrs Jacqueline Ejim, LCPC
	1040 Park Ave Ste 200, Baltimore, MD 21201-5634
	(443) 738-0300
	(443) 738-0301

Map and Direction

Healthcare Provider's Profile

Full Name	Mrs Jacqueline Ejim
Gender	Female
Speciality	Counselor - Professional
Location	1040 Park Ave Ste 200, Baltimore, Maryland
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1861920282
Provider Enumeration Date: 05/30/2017
Last Update Date: 10/06/2025

Medicare PECOS Information:

PECOS PAC ID: 0941628077
Enrollment ID: I20240916003942

Medical Identifiers

Medical identifiers for Mrs Jacqueline Ejim such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1861920282	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
101YP2500X	Counselor - Professional	LC7848 (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. Mrs Jacqueline Ejim allows following entities to bill medicare on her behalf.

Entity Name	Total Health Care Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1972597425 PECOS PAC ID: 0446258487 Enrollment ID: O20071107000802

Entity Name	Attt Counseling Services Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1164905188 PECOS PAC ID: 5799226874 Enrollment ID: O20240916003922

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. Mrs Jacqueline Ejim 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
Mrs Jacqueline Ejim, LCPC 1040 Park Ave Ste 200, Baltimore, MD 21201-5634 Ph: (443) 738-0300	Mrs Jacqueline Ejim, LCPC 1040 Park Ave Ste 200, Baltimore, MD 21201-5634 Ph: (443) 738-0300

Reviews and Comments

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Mrs Jacqueline Ejim, LCPC - Medicare Counselor in Baltimore, MD