Shakeyla Boulware, in Columbia, SC - Medicare Counselor Provider

Shakeyla Boulware, is a medicare enrolled "Counselor - Professional" provider in Columbia, South Carolina. Her current practice location is 2000 Park St Ste 101, Columbia, South Carolina. You can reach out to her office (for appointments etc.) via phone at (803) 319-2558.

Shakeyla Boulware is licensed to practice in South Carolina (license number 8980) 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 1437835501.

Contact Information

	Shakeyla Boulware,
	2000 Park St Ste 101, Columbia, SC 29201-2011
	(803) 319-2558
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Shakeyla Boulware
Gender	Female
Speciality	Counselor - Professional
Location	2000 Park St Ste 101, Columbia, South Carolina
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1437835501
Provider Enumeration Date: 06/23/2023
Last Update Date: 06/26/2025

Medicare PECOS Information:

PECOS PAC ID: 5799207270
Enrollment ID: I20250314000000

Medical Identifiers

Medical identifiers for Shakeyla Boulware such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1437835501	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
101YM0800X	Counselor - Mental Health	20301 (North Carolina)	Secondary
101YP2500X	Counselor - Professional	20301 (North Carolina)	Secondary
101YP2500X	Counselor - Professional	8980 (South Carolina)	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. Shakeyla Boulware allows following entities to bill medicare on her behalf.

Entity Name	Grow Healthcare Group Pa
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1245845932 PECOS PAC ID: 3476961368 Enrollment ID: O20221208000188

Entity Name	Mental Health Specialty Group Pa
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1801472634 PECOS PAC ID: 8921466228 Enrollment ID: O20240305000416

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. Shakeyla Boulware 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
Shakeyla Boulware, 2000 Park St Ste 101, Columbia, SC 29201-2011 Ph: (803) 319-2558	Shakeyla Boulware, 2000 Park St Ste 101, Columbia, SC 29201-2011 Ph: (803) 319-2558

Reviews and Comments

Counselor in Columbia, SC

Dr. Larry Barker, PH.D. Counselor Medicare: Not Enrolled in Medicare Practice Location: 122 Cardiff St, Columbia, SC 29209 Phone: 803-447-5585
Mr. Carlton A Andrews Iii, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 2611 River Dr, Columbia, SC 29201 Phone: 803-446-4905 Fax: 803-771-6685
Brenda Brooks, Counselor Medicare: Not Enrolled in Medicare Practice Location: 3809 Rosewood Dr, Columbia, SC 29205 Phone: 803-786-1844
Y'ticcia Y Williams, Counselor Medicare: Not Enrolled in Medicare Practice Location: 2715 Colonial Dr, Columbia, SC 29203 Phone: 803-898-4777
Dr. Mari Antoinette Alexander, PHD, LPC-MHSP Counselor Medicare: Not Enrolled in Medicare Practice Location: 2805 River Dr, Columbia, SC 29201 Phone: 617-777-6594 Fax: 617-221-3260
Nijoku Odom, Counselor Medicare: Not Enrolled in Medicare Practice Location: 2711 Colonial Dr, Columbia, SC 29203 Phone: 803-726-9351
Timothy Goode, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 235 Village Walk, Columbia, SC 29209 Phone: 417-343-9846

Shakeyla Boulware, - Medicare Counselor in Columbia, SC