Ms Jacqueline Dale Grantland, LCPC, NCC in Lexington Park, MD

Ms Jacqueline Dale Grantland, LCPC, NCC is a medicare enrolled "Counselor - Mental Health" provider in Lexington Park, Maryland. Her current practice location is 22776 Three Notch Rd Ste 210, Lexington Park, Maryland. You can reach out to her office (for appointments etc.) via phone at (301) 866-6333.

Ms Jacqueline Dale Grantland is licensed to practice in Maryland (license number LC4189) 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 1316905524.

Contact Information

	Ms Jacqueline Dale Grantland, LCPC, NCC
	22776 Three Notch Rd Ste 210, Lexington Park, MD 20653-3370
	(301) 866-6333
	(240) 718-1906

Map and Direction

Healthcare Provider's Profile

Full Name	Ms Jacqueline Dale Grantland
Gender	Female
Speciality	Counselor - Mental Health
Location	22776 Three Notch Rd Ste 210, Lexington Park, Maryland
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1316905524
Provider Enumeration Date: 05/04/2006
Last Update Date: 08/13/2023

Medicare PECOS Information:

PECOS PAC ID: 6406294602
Enrollment ID: I20250501002735

Medical Identifiers

Medical identifiers for Ms Jacqueline Dale Grantland such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1316905524	NPI	-	NPPES
6103219	Medicaid	NC
058356100	Medicaid	MD

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
101YM0800X	Counselor - Mental Health	5199 (North Carolina)	Secondary
101YM0800X	Counselor - Mental Health	LC4189 (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. Ms Jacqueline Dale Grantland allows following entities to bill medicare on her behalf.

Entity Name	Inner Peace Therapeutic Services Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1710303573 PECOS PAC ID: 4688012883 Enrollment ID: O20240408001258

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 Jacqueline Dale Grantland 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 Jacqueline Dale Grantland, LCPC, NCC Po Box 1662, Lexington Park, MD 20653-1662 Ph: (301) 863-8460	Ms Jacqueline Dale Grantland, LCPC, NCC 22776 Three Notch Rd Ste 210, Lexington Park, MD 20653-3370 Ph: (301) 866-6333

Reviews and Comments

Counselor in Lexington Park, MD

Miss Brittanny Ryan, LCPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 22776 Three Notch Rd Ste 102, Lexington Park, MD 20653 Phone: 301-866-6333 Fax: 240-718-1906
Bambii Kreal, CAC-AD Counselor Medicare: Not Enrolled in Medicare Practice Location: 21770 Franklin Delano Roosevelt Blvd, Lexington Park, MD 20653 Phone: 301-997-1300
William E Arick, LCPC, NCC, ACS Counselor Medicare: Not Enrolled in Medicare Practice Location: 46940 South Shangri-la Drive, Lexington Park, MD 20653 Phone: 301-862-4961 Fax: 301-862-5554
Amanda Kohut, ADT Counselor Medicare: Not Enrolled in Medicare Practice Location: 21770 Franklin Delano Roosevelt Blvd, Lexington Park, MD 20653 Phone: 301-997-1300
Taylor Winston, Counselor Medicare: Medicare Enrolled Practice Location: 22776 Three Notch Rd, Suite 210, Lexington Park, MD 20653 Phone: 301-866-6333
Amanda Mullins, Counselor Medicare: Not Enrolled in Medicare Practice Location: 21155 Lexwood Dr, Suite C, Lexington Park, MD 20653 Phone: 301-373-3065
Marie S Nazzaro, LCPC Counselor Medicare: Medicare Enrolled Practice Location: 21770 Fdr Blvd, Lexington Park, MD 20653 Phone: 301-997-1300 Fax: 301-866-9189

Ms Jacqueline Dale Grantland, LCPC, NCC - Medicare Counselor in Lexington Park, MD