Mrs Kristy Lynn Staten, LCSW is a medicare enrolled "Social Worker - Clinical" provider in Crystal Springs, Mississippi. Her current practice location is
506 W Marion Ave Ste A, Crystal Springs, Mississippi. You can reach out to her office (for appointments etc.) via phone at
(601) 497-8242.
Mrs Kristy Lynn Staten is licensed to practice in Mississippi (license number C8956) 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 1093321192.
Healthcare Provider's Profile
Full Name | Mrs Kristy Lynn Staten |
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Gender | Female |
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Speciality | Social Worker - Clinical |
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Location | 506 W Marion Ave Ste A, Crystal Springs, Mississippi |
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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: 1093321192
- Provider Enumeration Date: 09/23/2020
- Last Update Date: 09/23/2020
Medicare PECOS Information:
- PECOS PAC ID: 4385040237
- Enrollment ID: I20210901002307
Medical Identifiers
Medical identifiers for Mrs Kristy Lynn Staten such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1093321192 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
1041C0700X | Social Worker - Clinical | C8956 (Mississippi) | 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 Kristy Lynn Staten allows following entities to bill medicare on her behalf.
Entity Name | Psp Medical Clinic Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1932144243 PECOS PAC ID: 6406859446 Enrollment ID: O20060814000125 |
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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 Kristy Lynn Staten 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 Kristy Lynn Staten, LCSW 2575 Tank Rd, Terry, MS 39170-8394 Ph: (601) 951-4341 | Mrs Kristy Lynn Staten, LCSW 506 W Marion Ave Ste A, Crystal Springs, MS 39059-2720 Ph: (601) 497-8242 |
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