Shawna B Park, LISW-S, LCDC III is a medicare enrolled "Social Worker - Clinical" provider in Columbus, Ohio. Her current practice location is
2327 Gavinley Way, Columbus, Ohio. You can reach out to her office (for appointments etc.) via phone at
(216) 299-1517.
Shawna B Park is licensed to practice in Ohio (license number I.1101599) 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 1679822084.
Healthcare Provider's Profile
| Full Name | Shawna B Park |
|---|
| Gender | Female |
|---|
| Speciality | Social Worker - Clinical |
|---|
| Location | 2327 Gavinley Way, Columbus, Ohio |
|---|
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
|---|
NPI Data:
- NPI Number: 1679822084
- Provider Enumeration Date: 08/30/2012
- Last Update Date: 01/21/2015
Medicare PECOS Information:
- PECOS PAC ID: 1658523899
- Enrollment ID: I20121214000223
Medical Identifiers
Medical identifiers for Shawna B Park such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1679822084 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 10121 (Ohio) | Secondary |
| 1041C0700X | Social Worker - Clinical | I.1101599 (Ohio) | 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. Shawna B Park allows following entities to bill medicare on her behalf.
| Entity Name | Shawna Park Lisw-s, Llc |
|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
|---|
| Entity Identifiers | NPI Number: 1699164434
PECOS PAC ID: 2466776588
Enrollment ID: O20150121000572 |
|---|
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. Shawna B Park 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 |
|---|
Shawna B Park, LISW-S, LCDC III
2327 Gavinley Way,
Columbus, OH 43220-7335
Ph: (216) 299-1517 | Shawna B Park, LISW-S, LCDC III
2327 Gavinley Way,
Columbus, OH 43220-7335
Ph: (216) 299-1517 |
Reviews and Comments