Mrs Theppharack Ad Sounthala, MSW is a medicare enrolled "Social Worker - Clinical" provider in Modesto, California. She graduated from healthcare school in 2002 and has 24 years of diverse experience with area of expertise as Clinical Social Worker. She is a member of the group practice Golden Valley Health Centers and her current practice location is
251 E Hackett Rd, Modesto, California. You can reach out to her office (for appointments etc.) via phone at
(209) 558-2699.
Mrs Theppharack Ad Sounthala is licensed to practice in California (license number LCSW26225) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1083745780.
Healthcare Provider's Profile
| Full Name | Mrs Theppharack Ad Sounthala |
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| Gender | Female |
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| Speciality | Clinical Social Worker |
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| Experience | 24 Years |
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| Location | 251 E Hackett Rd, Modesto, California |
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| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Mrs Theppharack Ad Sounthala graduated from medical school in 2002
NPI Data:
- NPI Number: 1083745780
- Provider Enumeration Date: 03/07/2007
- Last Update Date: 06/02/2022
Medicare PECOS Information:
- PECOS PAC ID: 6800921719
- Enrollment ID: I20100317000757
Medical Identifiers
Medical identifiers for Mrs Theppharack Ad Sounthala such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1083745780 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 101YP2500X | Counselor - Professional | LCS 26225 (California) | Secondary |
| 1041C0700X | Social Worker - Clinical | LCSW26225 (California) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| Golden Valley Health Centers | 4183527187 | 114 |
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 Theppharack Ad Sounthala allows following entities to bill medicare on her behalf.
| Entity Name | Golden Valley Health Centers |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1356445753
PECOS PAC ID: 4183527187
Enrollment ID: O20040128000641 |
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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. Mrs Theppharack Ad Sounthala 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 |
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Mrs Theppharack Ad Sounthala, MSW
251 E Hackett Rd,
Modesto, CA 95358-9415
Ph: (209) 558-2699 | Mrs Theppharack Ad Sounthala, MSW
251 E Hackett Rd,
Modesto, CA 95358-9415
Ph: (209) 558-2699 |
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