Miss Marisa Helena Victory, PSYD, MA, MSW in Crown Point, IN

Miss Marisa Helena Victory, PSYD, MA, MSW is a medicare enrolled "Psychologist - Clinical" provider in Crown Point, Indiana. Her current practice location is 2100 N Main St Ste 304, Crown Point, Indiana. You can reach out to her office (for appointments etc.) via phone at (745) 461-9005.

Miss Marisa Helena Victory is licensed to practice in Indiana (license number 20043650B) 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 1902120629.

Contact Information

	Miss Marisa Helena Victory, PSYD, MA, MSW
	2100 N Main St Ste 304, Crown Point, IN 46307-1877
	(745) 461-9005
	(574) 546-1999

Map and Direction

Healthcare Provider's Profile

Full Name	Miss Marisa Helena Victory
Gender	Female
Speciality	Psychologist - Clinical
Location	2100 N Main St Ste 304, Crown Point, Indiana
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1902120629
Provider Enumeration Date: 03/24/2010
Last Update Date: 03/14/2024

Medicare PECOS Information:

PECOS PAC ID: 9234500513
Enrollment ID: I20230124002899

Medical Identifiers

Medical identifiers for Miss Marisa Helena Victory such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1902120629	NPI	-	NPPES
P.085240	Other	OH	STATE LICENSE

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
103TC0700X	Psychologist - Clinical	39154 (Texas)	Secondary
1041C0700X	Social Worker - Clinical	S.0901121 (Ohio)	Secondary
1041C0700X	Social Worker - Clinical	I.1201235 (Ohio)	Secondary
103TC0700X	Psychologist - Clinical	20043650B (Indiana)	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. Miss Marisa Helena Victory allows following entities to bill medicare on her behalf.

Entity Name	Neurology And Pain Management Associates Pc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1518900620 PECOS PAC ID: 4486676095 Enrollment ID: O20051223000201

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. Miss Marisa Helena Victory 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
Miss Marisa Helena Victory, PSYD, MA, MSW 312 Lochvale Peak Ct, Montgomery, TX 77316-2183 Ph: (614) 204-5602	Miss Marisa Helena Victory, PSYD, MA, MSW 2100 N Main St Ste 304, Crown Point, IN 46307-1877 Ph: (745) 461-9005

Reviews and Comments

Psychologist in Crown Point, IN

Adamantia Dina Leftakis, ED.S Psychologist Medicare: Not Enrolled in Medicare Practice Location: 1115 Ziegfield Ct, Crown Point, IN 46307 Phone: 219-308-2454
Dr. Alexander C. Kristevski, PSY.D. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 9330 S Broadway, Abj-va Outpatient Clinic, Crown Point, IN 46307 Phone: 219-662-5098
Robin Christian Shear, PH.D., HSPP Psychologist Medicare: Not Enrolled in Medicare Practice Location: 2100 N Main St Ste 304, Crown Point, IN 46307 Phone: 574-546-1900 Fax: 574-546-1999
Jonathan Royce Vandervlugt, LMHCA Psychologist Medicare: Not Enrolled in Medicare Practice Location: 9614 Granada Ct Apt 111, Crown Point, IN 46307 Phone: 773-732-1155
Dr. Victoria Colanese, PHD Psychologist Medicare: Accepting Medicare Assignments Practice Location: 2100 N Main St Ste 304, Crown Point, IN 46307 Phone: 574-546-1900
James Fenstermacher, PSYD Psychologist Medicare: Accepting Medicare Assignments Practice Location: 2100 N Main St Ste 304, Crown Point, IN 46307 Phone: 574-546-1900 Fax: 574-546-1999
Miceal C. Rooney, PSY.D. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 6685 E 117th Ave, Crown Point, IN 46307 Phone: 219-662-0642

Miss Marisa Helena Victory, PSYD, MA, MSW - Medicare Psychologist in Crown Point, IN