Ms Alicia Lynn Graham, LISW-S is a medicare enrolled "Social Worker - Clinical" provider in Archbold, Ohio. Her current practice location is
22251 State Route 2, Archbold, Ohio. You can reach out to her office (for appointments etc.) via phone at
(419) 445-1552.
Ms Alicia Lynn Graham is licensed to practice in Ohio (license number I.0800184-SUPV) 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 1790976744.
Healthcare Provider's Profile
| Full Name | Ms Alicia Lynn Graham |
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| Gender | Female |
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| Speciality | Social Worker - Clinical |
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| Location | 22251 State Route 2, Archbold, Ohio |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1790976744
- Provider Enumeration Date: 08/06/2007
- Last Update Date: 11/04/2024
Medicare PECOS Information:
- PECOS PAC ID: 9335287713
- Enrollment ID: I20140523000596
Medical Identifiers
Medical identifiers for Ms Alicia Lynn Graham such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1790976744 | NPI | - | NPPES |
| 0166914 | Medicaid | OH | |
| 1790976744 | Medicaid | OH | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YM0800X | Counselor - Mental Health | S.0500348 (Ohio) | Secondary |
| 104100000X | Social Worker | I.0800184 (Ohio) | Secondary |
| 1041C0700X | Social Worker - Clinical | I.0800184-SUPV (Ohio) | 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. Ms Alicia Lynn Graham allows following entities to bill medicare on her behalf.
| Entity Name | Shalom Ministries |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1366573552
PECOS PAC ID: 7911376033
Enrollment ID: O20221213001281 |
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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. Ms Alicia Lynn Graham 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 |
|---|
Ms Alicia Lynn Graham, LISW-S
17420 County Road 17f,
Bryan, OH 43506-9446
Ph: (419) 310-9524 | Ms Alicia Lynn Graham, LISW-S
22251 State Route 2,
Archbold, OH 43502-9452
Ph: (419) 445-1552 |
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