Laquesha Kameil Nicholson, LCSW is a medicare enrolled "Social Worker - Clinical" provider in Folcroft, Pennsylvania. Her current practice location is
2117 Ravenwood Rd, Folcroft, Pennsylvania. You can reach out to her office (for appointments etc.) via phone at
(267) 344-8384.
Laquesha Kameil Nicholson is licensed to practice in Pennsylvania (license number CW021101) 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 1306293907.
Healthcare Provider's Profile
Full Name | Laquesha Kameil Nicholson |
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Gender | Female |
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Speciality | Social Worker - Clinical |
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Location | 2117 Ravenwood Rd, Folcroft, Pennsylvania |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1306293907
- Provider Enumeration Date: 05/24/2016
- Last Update Date: 05/22/2020
Medicare PECOS Information:
- PECOS PAC ID: 3779903240
- Enrollment ID: I20201022000541
Medical Identifiers
Medical identifiers for Laquesha Kameil Nicholson such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1306293907 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
1041C0700X | Social Worker - Clinical | LCSW4549 (Hawaii) | Secondary |
1041C0700X | Social Worker - Clinical | CW021101 (Pennsylvania) | 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. Laquesha Kameil Nicholson allows following entities to bill medicare on her behalf.
Entity Name | Grow Healthcare Group Pa |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1245845932 PECOS PAC ID: 3476961368 Enrollment ID: O20220512002242 |
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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. Laquesha Kameil Nicholson 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 |
Laquesha Kameil Nicholson, LCSW Po Box 16353, Philadelphia, PA 19114-0453 Ph: (267) 344-8384 | Laquesha Kameil Nicholson, LCSW 2117 Ravenwood Rd, Folcroft, PA 19032-1510 Ph: (267) 344-8384 |
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