Ms Jennifer Noelle Pettijohn, LCSW in Pryor, OK - Medicare Social Worker Provider

Ms Jennifer Noelle Pettijohn, LCSW is a medicare enrolled "Social Worker - Clinical" provider in Pryor, Oklahoma. Her current practice location is 109 N Fairland St., Pryor, Oklahoma. You can reach out to her office (for appointments etc.) via phone at (918) 825-1405.

Ms Jennifer Noelle Pettijohn is licensed to practice in Oklahoma (license number 6246) 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 1295017614.

Contact Information

	Ms Jennifer Noelle Pettijohn, LCSW
	109 N Fairland St., Pryor, OK 74361-4203
	(918) 825-1405
	(918) 825-1406

Map and Direction

Healthcare Provider's Profile

Full Name	Ms Jennifer Noelle Pettijohn
Gender	Female
Speciality	Social Worker - Clinical
Location	109 N Fairland St., Pryor, Oklahoma
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1295017614
Provider Enumeration Date: 09/12/2011
Last Update Date: 02/11/2022

Medicare PECOS Information:

PECOS PAC ID: 1951522622
Enrollment ID: I20180809000974

Medical Identifiers

Medical identifiers for Ms Jennifer Noelle Pettijohn such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1295017614	NPI	-	NPPES
200372200A	Medicaid	OK

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
1041C0700X	Social Worker - Clinical	6246 (Oklahoma)	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. Ms Jennifer Noelle Pettijohn allows following entities to bill medicare on her behalf.

Entity Name	Grand Lake Mental Health Center, Inc.
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1497762520 PECOS PAC ID: 4688711534 Enrollment ID: O20091026000174

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. Ms Jennifer Noelle Pettijohn 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
Ms Jennifer Noelle Pettijohn, LCSW 109 N Fairland St., Pryor, OK 74361-4203 Ph: (918) 825-1405	Ms Jennifer Noelle Pettijohn, LCSW 109 N Fairland St., Pryor, OK 74361-4203 Ph: (918) 825-1405

Reviews and Comments

Social Worker in Pryor, OK

Tiffany Nicole Tottress, MSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 109 N Fairland St, Pryor, OK 74361 Phone: 918-825-1405 Fax: 918-825-1406
Floyd Grant, L.C.S.W. Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 109 N Fairland St, Suite 101, Pryor, OK 74361 Phone: 918-825-2884
Ms. Tiffany Jo Tomaso-kelly, LCSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 109 N Fairland St., Pryor, OK 74361 Phone: 918-629-3533
Christie Hilsheimer, LCSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 109 N Fairland St, Pryor, OK 74361 Phone: 918-825-1406 Fax: 918-876-3436
Allison Rose, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 109 N Fairland St, Pryor, OK 74361 Phone: 539-240-4411
Taylor Autumn Andoe, LMSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 109 N Fairland St, Pryor, OK 74361 Phone: 918-825-1405 Fax: 918-825-1406

Ms Jennifer Noelle Pettijohn, LCSW - Medicare Clinical Social Worker in Pryor, OK