Ms Laura Petiford, PMHNP, LMFT is a medicare enrolled "Nurse Practitioner - Psychiatric/mental Health" provider in Fairfield, Connecticut. Her current practice location is
1525 Kings Hwy, Suite 206, Fairfield, Connecticut. You can reach out to her office (for appointments etc.) via phone at
(203) 445-6238.
Ms Laura Petiford is licensed to practice in Connecticut (license number 006417) 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 1689818148.
Healthcare Provider's Profile
| Full Name | Ms Laura Petiford |
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| Gender | Female |
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| Speciality | Nurse Practitioner - Psychiatric/mental Health |
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| Location | 1525 Kings Hwy, Fairfield, Connecticut |
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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: 1689818148
- Provider Enumeration Date: 04/28/2009
- Last Update Date: 03/07/2016
Medicare PECOS Information:
- PECOS PAC ID: 3971892936
- Enrollment ID: I20160513000853
Medical Identifiers
Medical identifiers for Ms Laura Petiford such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1689818148 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 106H00000X | Marriage & Family Therapist | 001309 (Connecticut) | Secondary |
| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | 006417 (Connecticut) | 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 Laura Petiford allows following entities to bill medicare on her behalf.
| Entity Name | Jewish Family Service Of Stamford, Inc. |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1346291861
PECOS PAC ID: 9335124361
Enrollment ID: O20040623000081 |
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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 Laura Petiford 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 Laura Petiford, PMHNP, LMFT
66 Beaumont St,
Fairfield, CT 06824-5748
Ph: () - | Ms Laura Petiford, PMHNP, LMFT
1525 Kings Hwy, Suite 206,
Fairfield, CT 06824-5321
Ph: (203) 445-6238 |
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