Mr Charles Lucas Stephens, LMLP, LCP is a medicare enrolled "Psychologist - Group Psychotherapy" provider in Dodge City, Kansas. His current practice location is
11200 Lariat Way, Dodge City, Kansas. You can reach out to his office (for appointments etc.) via phone at
(620) 225-0276.
Mr Charles Lucas Stephens is licensed to practice in Kansas (license number 0136) 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 1245355361.
Healthcare Provider's Profile
| Full Name | Mr Charles Lucas Stephens |
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| Gender | Male |
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| Speciality | Psychologist - Group Psychotherapy |
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| Location | 11200 Lariat Way, Dodge City, Kansas |
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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: 1245355361
- Provider Enumeration Date: 03/20/2007
- Last Update Date: 07/09/2007
Medicare PECOS Information:
- PECOS PAC ID: 4587007547
- Enrollment ID: I20240206003910
Medical Identifiers
Medical identifiers for Mr Charles Lucas Stephens such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1245355361 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 103T00000X | Psychologist | 0141 (Kansas) | Primary |
| 103T00000X | Psychologist | 0136 (Kansas) | Primary |
| 103TP2701X | Psychologist - Group Psychotherapy | 0141 (Kansas) | Primary |
| 103TP2701X | Psychologist - Group Psychotherapy | 0136 (Kansas) | 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. Mr Charles Lucas Stephens allows following entities to bill medicare on his behalf.
| Entity Name | Iroquois Center For Human Development, Inc. |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1922001981
PECOS PAC ID: 2062314081
Enrollment ID: O20040915000321 |
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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. Mr Charles Lucas Stephens 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 |
|---|
Mr Charles Lucas Stephens, LMLP, LCP
900 W Broadway St,
Newton, KS 67114-2037
Ph: (316) 283-1950 | Mr Charles Lucas Stephens, LMLP, LCP
11200 Lariat Way,
Dodge City, KS 67801-7328
Ph: (620) 225-0276 |
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