Cindy L Fonseca-shivers, LPC, LCSW is a medicare enrolled "Counselor - Professional" provider in Green Bay, Wisconsin. Her current practice location is
1794 Allouez Ave, Suite C, Number 243, Green Bay, Wisconsin. You can reach out to her office (for appointments etc.) via phone at
(920) 367-4025.
Cindy L Fonseca-shivers is licensed to practice in Wisconsin (license number 2359-125) 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 1700165867.
Healthcare Provider's Profile
| Full Name | Cindy L Fonseca-shivers |
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| Gender | Female |
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| Speciality | Counselor - Professional |
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| Location | 1794 Allouez Ave, Green Bay, Wisconsin |
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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: 1700165867
- Provider Enumeration Date: 08/08/2011
- Last Update Date: 02/12/2024
Medicare PECOS Information:
- PECOS PAC ID: 3971753963
- Enrollment ID: I20240314002058
Medical Identifiers
Medical identifiers for Cindy L Fonseca-shivers such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1700165867 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 1041C0700X | Social Worker - Clinical | 4233-123 (Wisconsin) | Secondary |
| 101YP2500X | Counselor - Professional | 2359-125 (Wisconsin) | 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. Cindy L Fonseca-shivers allows following entities to bill medicare on her behalf.
| Entity Name | Lavender Skies Counseling Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1235990698
PECOS PAC ID: 5597101683
Enrollment ID: O20240312001122 |
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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. Cindy L Fonseca-shivers 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 |
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Cindy L Fonseca-shivers, LPC, LCSW
1794 Allouez Ave, Suite C, Number 243,
Green Bay, WI 54311-6281
Ph: (920) 367-4025 | Cindy L Fonseca-shivers, LPC, LCSW
1794 Allouez Ave, Suite C, Number 243,
Green Bay, WI 54311-6281
Ph: (920) 367-4025 |
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