Mrs Susan Louise Brocklesby, LMSW is a medicare enrolled "Counselor - Mental Health" provider in Mulvane, Kansas. Her current practice location is
10950 S 143rd St E, Mulvane, Kansas. You can reach out to her office (for appointments etc.) via phone at
(316) 409-4782.
Mrs Susan Louise Brocklesby is licensed to practice in Kansas (license number 7572) 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 1104417807.
Healthcare Provider's Profile
Full Name | Mrs Susan Louise Brocklesby |
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Gender | Female |
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Speciality | Counselor - Mental Health |
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Location | 10950 S 143rd St E, Mulvane, Kansas |
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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: 1104417807
- Provider Enumeration Date: 01/27/2021
- Last Update Date: 01/27/2021
Medicare PECOS Information:
- PECOS PAC ID: 5597157545
- Enrollment ID: I20220125000460
Medical Identifiers
Medical identifiers for Mrs Susan Louise Brocklesby such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1104417807 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
101YM0800X | Counselor - Mental Health | 7572 (Kansas) | Primary |
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 Susan Louise Brocklesby 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 Susan Louise Brocklesby, LMSW 10950 S 143rd St E, Mulvane, KS 67110-9451 Ph: (316) 409-4782 | Mrs Susan Louise Brocklesby, LMSW 10950 S 143rd St E, Mulvane, KS 67110-9451 Ph: (316) 409-4782 |
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