Slade F Thackeray, LPC in Dallas, OR - Medicare Counselor Provider

Slade F Thackeray, LPC is a medicare enrolled "Counselor" provider in Dallas, Oregon. His current practice location is 1151 Sw Levens St, Dallas, Oregon. You can reach out to his office (for appointments etc.) via phone at (503) 910-6822.

Slade F Thackeray is licensed to practice in Oregon (license number C8279) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1992460703.

Contact Information

	Slade F Thackeray, LPC
	1151 Sw Levens St, Dallas, OR 97338-2266
	(503) 910-6822
	(971) 357-2444

Map and Direction

Healthcare Provider's Profile

Full Name	Slade F Thackeray
Gender	Male
Speciality	Counselor
Location	1151 Sw Levens St, Dallas, Oregon
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1992460703
Provider Enumeration Date: 11/05/2021
Last Update Date: 05/28/2024

Medicare PECOS Information:

PECOS PAC ID: 3274076286
Enrollment ID: I20240619000311

Medical Identifiers

Medical identifiers for Slade F Thackeray such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1992460703	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
101Y00000X	Counselor	C8279 (Oregon)	Primary
101YM0800X	Counselor - Mental Health	(* (Not Available))	Secondary

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. Slade F Thackeray allows following entities to bill medicare on his behalf.

Entity Name	Mindful Therapy Group Pc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1316238678 PECOS PAC ID: 4981872561 Enrollment ID: O20210301001586

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. Slade F Thackeray 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
Slade F Thackeray, LPC 1151 Sw Levens St, Dallas, OR 97338-2266 Ph: (503) 910-6822	Slade F Thackeray, LPC 1151 Sw Levens St, Dallas, OR 97338-2266 Ph: (503) 910-6822

Reviews and Comments

Counselor in Dallas, OR

Kimberly Dawn Howard, QMHA Counselor Medicare: Not Enrolled in Medicare Practice Location: 182 Sw Academy St, Suite 304, Dallas, OR 97338 Phone: 503-623-9289 Fax: 503-831-1726
Jedonne Jorstad, BA Counselor Medicare: Not Enrolled in Medicare Practice Location: 182 Sw Academy St, Ste 304, Dallas, OR 97338 Phone: 503-623-9289 Fax: 503-623-1874
Zachary Beeler, Counselor Medicare: Not Enrolled in Medicare Practice Location: 182 Sw Academy St, Dallas, OR 97338 Phone: 503-623-9289
Katrina Jeannine West, QMHP Counselor Medicare: Not Enrolled in Medicare Practice Location: 182 Sw Academy St, Dallas, OR 97338 Phone: 503-623-9289
Susan Marie Klein, Counselor Medicare: Not Enrolled in Medicare Practice Location: 182 Sw Academy St, Suite 304, Dallas, OR 97338 Phone: 503-623-9289
Mrs. Margaret Ann Terry, M.A. Counselor Medicare: Not Enrolled in Medicare Practice Location: 182 Sw Academy St, Dallas, OR 97338 Phone: 503-623-9289
Tiffany Bouchard, MS, NCC Counselor Medicare: Not Enrolled in Medicare Practice Location: 182 Sw Academy St, County Of Polk, Suite 220, Dallas, OR 97338 Phone: 503-623-9317

Slade F Thackeray, LPC - Medicare Counselor in Dallas, OR