Mrs Mallory Breanne Libbert, MS, CCC-SLP in Jasper, IN - Medicare Speech-Language Pathologist Provider

Mrs Mallory Breanne Libbert, MS, CCC-SLP is a medicare enrolled "Speech-language Pathologist" provider in Jasper, Indiana. Her current practice location is 3150 Saint Charles St, Jasper, Indiana. You can reach out to her office (for appointments etc.) via phone at (812) 634-6570.

Mrs Mallory Breanne Libbert is licensed to practice in Indiana (license number 22006418A) 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 1619686391.

Contact Information

	Mrs Mallory Breanne Libbert, MS, CCC-SLP
	3150 Saint Charles St, Jasper, IN 47546-1858
	(812) 634-6570
	(812) 634-7919

Map and Direction

Healthcare Provider's Profile

Full Name	Mrs Mallory Breanne Libbert
Gender	Female
Speciality	Speech-language Pathologist
Location	3150 Saint Charles St, Jasper, Indiana
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1619686391
Provider Enumeration Date: 11/21/2022
Last Update Date: 11/21/2022

Medicare PECOS Information:

PECOS PAC ID: 6103297387
Enrollment ID: I20230126000680

Medical Identifiers

Medical identifiers for Mrs Mallory Breanne Libbert such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1619686391	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
235Z00000X	Speech-language Pathologist	22006418A (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. Mrs Mallory Breanne Libbert allows following entities to bill medicare on her behalf.

Provider Name	Legacy Therapy And Rehabilitation Llc
Provider Type	Part B Supplier - Clinic/group Practice
Provider Identifiers	NPI Number: 1023743614 PECOS PAC ID: 8325421472 Enrollment ID: O20220823000515

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. Mrs Mallory Breanne Libbert 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
Mrs Mallory Breanne Libbert, MS, CCC-SLP 2131 W 5th Ave, Jasper, IN 47546-9720 Ph: (812) 827-1062	Mrs Mallory Breanne Libbert, MS, CCC-SLP 3150 Saint Charles St, Jasper, IN 47546-1858 Ph: (812) 634-6570

Reviews and Comments

Speech-Language Pathologist in Jasper, IN

Mary L. Zehr Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 1150 W Ann Ln, Jasper, IN 47546 Phone: 812-631-1617 Fax: 812-634-1450
Mrs. Amanda Sue Kemper, MA-CCC, SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 2909 Howard Dr, Jasper, IN 47546 Phone: 812-482-6161
Ashley Mitchell, SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 1603 Mill St, Jasper, IN 47546 Phone: 812-639-1031
Brandy Lemen, Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 701 Keusch Ln, Jasper, IN 47546 Phone: 812-309-1575
Kendall Renee Sermerseim, Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 2515 Newton St, Jasper, IN 47546 Phone: 812-482-1722
Mrs. Nancy Maureen Knies, MA, CCC-SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 1791 Raymond St, Jasper, IN 47546 Phone: 812-482-5987 Fax: 812-482-5987
Kristin Jolene Knies Schitter, MA., CCC-SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 671 3rd Ave, Jasper, IN 47546 Phone: 812-630-2833 Fax: 812-301-1329

Mrs Mallory Breanne Libbert, MS, CCC-SLP - Medicare Speech-Language Pathologist in Jasper, IN