Ms Theresa Bergold, LMSW is a medicare enrolled "Social Worker - Clinical" provider in Lake Ronkonkoma, New York. She graduated from healthcare school in 2013 and has 13 years of diverse experience with area of expertise as Clinical Social Worker. She is a member of the group practice Central Nassau Guidance And Counseling Services, Inc. and her current practice location is
161 Lake Shore Rd, Lake Ronkonkoma, New York. You can reach out to her office (for appointments etc.) via phone at
(631) 471-5666.
Ms Theresa Bergold is licensed to practice in New York (license number 096848) 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 1831613868.
Healthcare Provider's Profile
| Full Name | Ms Theresa Bergold |
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| Gender | Female |
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| Speciality | Clinical Social Worker |
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| Experience | 13 Years |
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| Location | 161 Lake Shore Rd, Lake Ronkonkoma, New York |
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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 Theresa Bergold graduated from medical school in 2013
NPI Data:
- NPI Number: 1831613868
- Provider Enumeration Date: 08/01/2017
- Last Update Date: 08/02/2024
Medicare PECOS Information:
- PECOS PAC ID: 8628416658
- Enrollment ID: I20240409004206
Medical Identifiers
Medical identifiers for Ms Theresa Bergold such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1831613868 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Secondary |
| 1041C0700X | Social Worker - Clinical | 096848 (New York) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Central Nassau Guidance And Counseling Services, Inc. | 6406747401 | 28 |
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 Theresa Bergold allows following entities to bill medicare on her behalf.
| Entity Name | Central Nassau Guidance & Counseling Services, Inc. |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1114928462
PECOS PAC ID: 6406747401
Enrollment ID: O20040322000050 |
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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 Theresa Bergold 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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Ms Theresa Bergold, LMSW
10 Railroad Ave Apt 4,
Bethpage, NY 11714-3000
Ph: () - | Ms Theresa Bergold, LMSW
161 Lake Shore Rd,
Lake Ronkonkoma, NY 11779-3182
Ph: (631) 471-5666 |
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