Mrs Elizabeth Anne Dominguez, LCSW in Norwich, CT - Medicare Social Worker Provider

Mrs Elizabeth Anne Dominguez, LCSW is a medicare enrolled "Social Worker - Clinical" provider in Norwich, Connecticut. Her current practice location is 401 West Thames Street, Southeastern Mental Health Authority Bldg 301, Norwich, Connecticut. You can reach out to her office (for appointments etc.) via phone at (860) 859-4674.

Mrs Elizabeth Anne Dominguez is licensed to practice in Connecticut (license number 005777) 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 1184784886.

Contact Information

	Mrs Elizabeth Anne Dominguez, LCSW
	401 West Thames Street, Southeastern Mental Health Authority Bldg 301, Norwich, CT 06360
	(860) 859-4674
	(860) 859-4790

Map and Direction

Healthcare Provider's Profile

Full Name	Mrs Elizabeth Anne Dominguez
Gender	Female
Speciality	Social Worker - Clinical
Location	401 West Thames Street, Norwich, Connecticut
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1184784886
Provider Enumeration Date: 12/11/2006
Last Update Date: 07/08/2007

Medicare PECOS Information:

PECOS PAC ID: 2769445824
Enrollment ID: I20041109001024

Medical Identifiers

Medical identifiers for Mrs Elizabeth Anne Dominguez such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1184784886	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
1041C0700X	Social Worker - Clinical	005777 (Connecticut)	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 Elizabeth Anne Dominguez allows following entities to bill medicare on her behalf.

Entity Name	State Of Connecticut
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1902831548 PECOS PAC ID: 8022915677 Enrollment ID: O20040319000291

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 Elizabeth Anne Dominguez 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 Elizabeth Anne Dominguez, LCSW 401 West Thames Street, Southeastern Mental Health Authority Bldg 301, Norwich, CT 06360 Ph: (860) 859-4674	Mrs Elizabeth Anne Dominguez, LCSW 401 West Thames Street, Southeastern Mental Health Authority Bldg 301, Norwich, CT 06360 Ph: (860) 859-4674

Reviews and Comments

Social Worker in Norwich, CT

Julie A Martin, LCSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 47 Town St, Norwich, CT 06360 Phone: 860-892-7042 Fax: 860-823-3060
Mrs. Jennifer Alice Tattersall, LCSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 62 Broadway Ste 1, Norwich, CT 06360 Phone: 860-639-6880
Laurie Giemza, LCSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 42 Town St Ste 300, Norwich, CT 06360 Phone: 860-886-0567
Robert V Scialabba, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 326 Washington St, William W Backus Hospital, Norwich, CT 06360 Phone: 860-889-8331
Ms. Lindsay Marie Melazzo, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 55 Main St, Suite 408, Norwich, CT 06360 Phone: 860-885-6054
Stacy Mesyna, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 47 Town St, Norwich, CT 06360 Phone: 860-892-7042
Michelle Gienau, LCSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 47 Town St, Norwich, CT 06360 Phone: 860-892-7040

Mrs Elizabeth Anne Dominguez, LCSW - Medicare Clinical Social Worker in Norwich, CT