Ms Mary Irene Sullivan, LPCC LPC is a medicare enrolled "Counselor - Professional" provider in Bellflower, Missouri. She graduated from healthcare school in 1989 and has 36 years of diverse experience with area of expertise as Mental Health Counselor. She is a member of the group practice Encounter Telehealth Inc and her current practice location is
11 Mabry Rd, Bellflower, Missouri. You can reach out to her office (for appointments etc.) via phone at
(715) 426-9877.
Ms Mary Irene Sullivan is licensed to practice in Missouri (license number 2021009968) 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 1295978153.
Healthcare Provider's Profile
| Full Name | Ms Mary Irene Sullivan |
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| Gender | Female |
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| Speciality | Mental Health Counselor |
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| Experience | 36 Years |
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| Location | 11 Mabry Rd, Bellflower, Missouri |
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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:
- Ms Mary Irene Sullivan graduated from medical school in 1989
NPI Data:
- NPI Number: 1295978153
- Provider Enumeration Date: 04/08/2009
- Last Update Date: 06/19/2023
Medicare PECOS Information:
- PECOS PAC ID: 0244670198
- Enrollment ID: I20240425003705
Medical Identifiers
Medical identifiers for Ms Mary Irene Sullivan such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1295978153 | NPI | - | NPPES |
| 2021009968 | Other | MO | LICENSED PROFESSIONAL COUNSELOR |
| CC00181 | Other | MN | STATE OF MINNESOTA BOARD OF BEHAVIORAL HEALTH AND THERAPY |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YP2500X | Counselor - Professional | 00181 (Minnesota) | Secondary |
| 101YP2500X | Counselor - Professional | 2021009968 (Missouri) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| Encounter Telehealth Inc | 9931348307 | 17 |
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 Mary Irene Sullivan allows following entities to bill medicare on her behalf.
| Entity Name | Encounter Telehealth, Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1922342195
PECOS PAC ID: 9931348307
Enrollment ID: O20170407001641 |
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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 Mary Irene Sullivan 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 Mary Irene Sullivan, LPCC LPC
11 Mabry Rd,
Bellflower, MO 63333-2303
Ph: (715) 426-8777 | Ms Mary Irene Sullivan, LPCC LPC
11 Mabry Rd,
Bellflower, MO 63333-2303
Ph: (715) 426-9877 |
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