Dominique Latrece Squire, LCSW in Winterville, NC - Medicare Social Worker Provider

Dominique Latrece Squire, LCSW is a medicare enrolled "Social Worker - Clinical" provider in Winterville, North Carolina. Her current practice location is 575 S Square Dr Apt 103, Winterville, North Carolina. You can reach out to her office (for appointments etc.) via phone at (919) 423-7483.

Dominique Latrece Squire is licensed to practice in North Carolina (license number C017135) 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 1174125322.

Contact Information

	Dominique Latrece Squire, LCSW
	575 S Square Dr Apt 103, Winterville, NC 28590-8699
	(919) 423-7483
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Dominique Latrece Squire
Gender	Female
Speciality	Social Worker - Clinical
Location	575 S Square Dr Apt 103, Winterville, North Carolina
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1174125322
Provider Enumeration Date: 11/12/2020
Last Update Date: 05/22/2024

Medicare PECOS Information:

PECOS PAC ID: 6002355625
Enrollment ID: I20240827004675

Medical Identifiers

Medical identifiers for Dominique Latrece Squire such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1174125322	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
1041C0700X	Social Worker - Clinical	C017135 (North Carolina)	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. Dominique Latrece Squire allows following entities to bill medicare on her behalf.

Entity Name	Grow Healthcare Group Pa
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1245845932 PECOS PAC ID: 3476961368 Enrollment ID: O20221208000188

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. Dominique Latrece Squire 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
Dominique Latrece Squire, LCSW 575 S Square Dr Apt 103, Winterville, NC 28590-8699 Ph: (919) 423-7483	Dominique Latrece Squire, LCSW 575 S Square Dr Apt 103, Winterville, NC 28590-8699 Ph: (919) 423-7483

Reviews and Comments

Social Worker in Winterville, NC

Lauralee Selvina Fuhrmann, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 500 Holly Grove Dr, Winterville, NC 28590 Phone: 252-422-7444
Ms. Dayna Farrington, LCSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 150 E Fire Tower Rd Ste C, Winterville, NC 28590 Phone: 252-916-8268
Mrs. Yolanda Roshel Soney, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1403 Trafalgar Rd, Winterville, NC 28590 Phone: 252-830-2149
Ms. Katie Jane Leegins-vinson, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 154 Beacon Dr, Suite I, Winterville, NC 28590 Phone: 252-353-1114 Fax: 252-353-1119
Savannah Leigh Black, LCSW-A Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 610a Old Tar Village Rd, Winterville, NC 28590 Phone: 252-364-8972 Fax: 252-364-8971
Kristian Backman, LCSWA Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 2040 S Park Dr Ste F, Winterville, NC 28590 Phone: 252-751-0865

Dominique Latrece Squire, LCSW - Medicare Clinical Social Worker in Winterville, NC