Shontanae Imani Green, MS, LPC, NCC in Grovetown, GA

Shontanae Imani Green, MS, LPC, NCC is a medicare enrolled "Counselor - Mental Health" provider in Grovetown, Georgia. Her current practice location is 247 Sassafras Ln, Grovetown, Georgia. You can reach out to her office (for appointments etc.) via phone at (706) 631-1882.

Shontanae Imani Green is licensed to practice in Georgia (license number LPC014138) 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 1134885411.

Contact Information

	Shontanae Imani Green, MS, LPC, NCC
	247 Sassafras Ln, Grovetown, GA 30813-7300
	(706) 631-1882
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Shontanae Imani Green
Gender	Female
Speciality	Counselor - Mental Health
Location	247 Sassafras Ln, Grovetown, Georgia
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1134885411
Provider Enumeration Date: 11/11/2021
Last Update Date: 09/19/2023

Medicare PECOS Information:

PECOS PAC ID: 9931620192
Enrollment ID: I20250305000910

Medical Identifiers

Medical identifiers for Shontanae Imani Green such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1134885411	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
101YM0800X	Counselor - Mental Health	LPC014138 (Georgia)	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. Shontanae Imani Green 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: O20220315000829

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. Shontanae Imani Green 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
Shontanae Imani Green, MS, LPC, NCC 247 Sassafras Ln, Grovetown, GA 30813-7300 Ph: (706) 631-1882	Shontanae Imani Green, MS, LPC, NCC 247 Sassafras Ln, Grovetown, GA 30813-7300 Ph: (706) 631-1882

Reviews and Comments

Counselor in Grovetown, GA

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Shontanae Imani Green, MS, LPC, NCC - Medicare Counselor in Grovetown, GA