Mrs Andrea Dawn Holley, MSW, LCSW is a medicare enrolled "Counselor - Mental Health" provider in Hugo, Oklahoma. Her current practice location is
2402 Tanglewood Ln, Hugo, Oklahoma. You can reach out to her office (for appointments etc.) via phone at
(580) 372-0933.
Mrs Andrea Dawn Holley is licensed to practice in Oklahoma (license number 4060) 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 1679796189.
Healthcare Provider's Profile
Full Name | Mrs Andrea Dawn Holley |
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Gender | Female |
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Speciality | Counselor - Mental Health |
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Location | 2402 Tanglewood Ln, Hugo, Oklahoma |
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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: 1679796189
- Provider Enumeration Date: 04/11/2007
- Last Update Date: 06/06/2024
Medicare PECOS Information:
- PECOS PAC ID: 0143525352
- Enrollment ID: I20160225002660
Medical Identifiers
Medical identifiers for Mrs Andrea Dawn Holley such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1679796189 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
1041C0700X | Social Worker - Clinical | (* (Not Available)) | Secondary |
101YM0800X | Counselor - Mental Health | 4060 (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. Mrs Andrea Dawn Holley allows following entities to bill medicare on her behalf.
Entity Name | Community Pathways Unlimited Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1659328284 PECOS PAC ID: 6608776349 Enrollment ID: O20040109001005 |
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Entity Name | Riverbend Counseling Services Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1679821912 PECOS PAC ID: 3274813647 Enrollment ID: O20161201001758 |
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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. Mrs Andrea Dawn Holley 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 Andrea Dawn Holley, MSW, LCSW 2402 Tanglewood Ln, Hugo, OK 74743-8507 Ph: (580) 372-0933 | Mrs Andrea Dawn Holley, MSW, LCSW 2402 Tanglewood Ln, Hugo, OK 74743-8507 Ph: (580) 372-0933 |
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