Ms Samonia Lynn Etheridge, LPC in Vicksburg, MS - Medicare Mental Health Counselor Provider

Ms Samonia Lynn Etheridge, LPC is a medicare enrolled "Counselor - Professional" provider in Vicksburg, Mississippi. She graduated from healthcare school in 2001 and has 25 years of diverse experience with area of expertise as Mental Health Counselor. She is a member of the group practice Right Track Medical Group, Inc and her current practice location is 1414 Cherry St, Vicksburg, Mississippi. You can reach out to her office (for appointments etc.) via phone at (601) 636-5703.

Ms Samonia Lynn Etheridge is licensed to practice in Mississippi (license number 1046) 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 1619014891.

Contact Information

	Ms Samonia Lynn Etheridge, LPC
	1414 Cherry St, Vicksburg, MS 39180-3218
	(601) 636-5703
	(601) 636-5739

Map and Direction

Healthcare Provider's Profile

Full Name	Ms Samonia Lynn Etheridge
Gender	Female
Speciality	Mental Health Counselor
Experience	25 Years
Location	1414 Cherry St, Vicksburg, Mississippi
Accepts Medicare Assignments	Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Ms Samonia Lynn Etheridge graduated from medical school in 2001

NPI Data:

NPI Number: 1619014891
Provider Enumeration Date: 01/30/2007
Last Update Date: 07/08/2007

Medicare PECOS Information:

PECOS PAC ID: 0042650756
Enrollment ID: I20240429002233

Medical Identifiers

Medical identifiers for Ms Samonia Lynn Etheridge such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1619014891	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
101YP2500X	Counselor - Professional	1046 (Mississippi)	Primary

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Right Track Medical Group, Inc	8729403415	24

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 Samonia Lynn Etheridge allows following entities to bill medicare on her behalf.

Entity Name	Grace Christian Counseling Center
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1447295654 PECOS PAC ID: 0749285070 Enrollment ID: O20240130002733

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 Samonia Lynn Etheridge 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 Samonia Lynn Etheridge, LPC 1414 Cherry St, Vicksburg, MS 39180-3218 Ph: (601) 636-5703	Ms Samonia Lynn Etheridge, LPC 1414 Cherry St, Vicksburg, MS 39180-3218 Ph: (601) 636-5703

Reviews and Comments

Counselor in Vicksburg, MS

Kaila Virgil, Counselor Medicare: Not Enrolled in Medicare Practice Location: 3334 Wisconsin Ave., Vicksburg, MS 39180 Phone: 601-638-0031
Tiffany Smith, Counselor Medicare: Not Enrolled in Medicare Practice Location: 3444 Wisconsin Ave, Vicksburg, MS 39180 Phone: 601-638-0031 Fax: 601-638-4950
Felicia Wilson, PCMHT Counselor Medicare: Not Enrolled in Medicare Practice Location: 3444 Wisconsin Ave, Vicksburg, MS 39180 Phone: 601-638-0031 Fax: 601-638-4950
Heather Potts, Counselor Medicare: Not Enrolled in Medicare Practice Location: 3444 Wisconsin Ave, Vicksburg, MS 39180 Phone: 601-638-0031
Rosalyn Glascoe, Counselor Medicare: Not Enrolled in Medicare Practice Location: 3444 Wisconsin Ave, Vicksburg, MS 39180 Phone: 601-638-0031
Ann Nelson, LSW Counselor Medicare: Not Enrolled in Medicare Practice Location: 3444 Wisconsin Ave, Vicksburg, MS 39180 Phone: 601-638-0031 Fax: 601-638-4950
Mr. Walter Lee Frazier, MCP, LPC, NCC Counselor Medicare: Accepting Medicare Assignments Practice Location: 1414 Cherry St, Vicksburg, MS 39180 Phone: 601-636-5703 Fax: 601-636-5739

Ms Samonia Lynn Etheridge, LPC - Medicare Counselor in Vicksburg, MS