Mrs Stephanie Anne Blackburn, LCSW in Charlotte, NC

Mrs Stephanie Anne Blackburn, LCSW is a medicare enrolled "Social Worker - Clinical" provider in Charlotte, North Carolina. Her current practice location is 4412 Park Rd, Charlotte, North Carolina. You can reach out to her office (for appointments etc.) via phone at (980) 217-6901.

Mrs Stephanie Anne Blackburn is licensed to practice in North Carolina (license number C007732) 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 1700197159.

Contact Information

	Mrs Stephanie Anne Blackburn, LCSW
	4412 Park Rd, Charlotte, NC 28209-3130
	(980) 217-6901
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Mrs Stephanie Anne Blackburn
Gender	Female
Speciality	Social Worker - Clinical
Location	4412 Park Rd, Charlotte, North Carolina
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1700197159
Provider Enumeration Date: 06/30/2010
Last Update Date: 01/10/2024

Medicare PECOS Information:

PECOS PAC ID: 1456704865
Enrollment ID: I20240201000264

Medical Identifiers

Medical identifiers for Mrs Stephanie Anne Blackburn such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1700197159	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
1041C0700X	Social Worker - Clinical	C007732 (North Carolina)	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 Stephanie Anne Blackburn allows following entities to bill medicare on her behalf.

Entity Name	Thriveworks Clinical - North Carolina Pc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1003303082 PECOS PAC ID: 8527471200 Enrollment ID: O20210120000669

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 Stephanie Anne Blackburn 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 Stephanie Anne Blackburn, LCSW 7503 Potter Rd S, Waxhaw, NC 28173-9242 Ph: (704) 759-6168	Mrs Stephanie Anne Blackburn, LCSW 4412 Park Rd, Charlotte, NC 28209-3130 Ph: (980) 217-6901

Reviews and Comments

Social Worker in Charlotte, NC

Ms. Latonya Latrice Pompey, MSW, P-LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 5633 Monroe Rd, Suite D, Charlotte, NC 28212 Phone: 843-356-0719
Miss Meredith Canty Anderson, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 2512 Wingdale Dr, Charlotte, NC 28213 Phone: 843-230-6359
Anastashia Natasha Brown, LCSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 3541 Randolph Rd, Ste 210, Charlotte, NC 28211 Phone: 704-381-8336
Denise Doster, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 10801 Johnston Rd, Suite 227, Charlotte, NC 28226 Phone: 980-299-1277
Sara Charles Goguen, MSW, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 2125 Southend Dr, Suite 452, Charlotte, NC 28203 Phone: 704-378-1390 Fax: 704-378-1392
Mr. Andre Maurice Harvey, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 9711 David Taylor Dr Apt 104, Charlotte, NC 28262 Phone: 980-202-2526
Melissa Elder, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 3111 Springbank Ln, Suite G, Charlotte, NC 28226 Phone: 980-288-8595

Mrs Stephanie Anne Blackburn, LCSW - Medicare Clinical Social Worker in Charlotte, NC