Ms Winell Jenetta Soures, LCSW-R, SAP, MSW,MA is a medicare enrolled "Social Worker - Clinical" provider in Albany, New York. Her current practice location is
650 Warren St, Albany, New York. You can reach out to her office (for appointments etc.) via phone at
(518) 462-6531.
Ms Winell Jenetta Soures is licensed to practice in New York (license number R087957-01) 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 1336433846.
Healthcare Provider's Profile
| Full Name | Ms Winell Jenetta Soures |
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| Gender | Female |
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| Speciality | Social Worker - Clinical |
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| Location | 650 Warren St, Albany, New York |
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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: 1336433846
- Provider Enumeration Date: 06/01/2011
- Last Update Date: 04/22/2022
Medicare PECOS Information:
- PECOS PAC ID: 1850767492
- Enrollment ID: I20221021002051
Medical Identifiers
Medical identifiers for Ms Winell Jenetta Soures such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1336433846 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 25106 (New York) | Secondary |
| 1041C0700X | Social Worker - Clinical | 087957-01 (New York) | Secondary |
| 1041C0700X | Social Worker - Clinical | R087957-01 (New York) | 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 Winell Jenetta Soures allows following entities to bill medicare on her behalf.
| Entity Name | Tidemark Therapy Pllc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1275939001
PECOS PAC ID: 7416283775
Enrollment ID: O20190724000985 |
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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 Winell Jenetta Soures 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 Winell Jenetta Soures, LCSW-R, SAP, MSW,MA
650 Warren St,
Albany, NY 12208-2998
Ph: (518) 462-6531 | Ms Winell Jenetta Soures, LCSW-R, SAP, MSW,MA
650 Warren St,
Albany, NY 12208-2998
Ph: (518) 462-6531 |
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