Ms Tina Celeste Outlaw, BSW,MSW, LISW-CP is a medicare enrolled "Social Worker - Clinical" provider in Lamar, South Carolina. Her current practice location is
2919 Jeffords Rd N, Outlaw's Vision Quest Farm, Inc., Lamar, South Carolina. You can reach out to her office (for appointments etc.) via phone at
(843) 857-0298.
Ms Tina Celeste Outlaw is licensed to practice in South Carolina (license number 5160) 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 1407911332.
Healthcare Provider's Profile
| Full Name | Ms Tina Celeste Outlaw |
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| Gender | Female |
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| Speciality | Social Worker - Clinical |
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| Location | 2919 Jeffords Rd N, Lamar, South Carolina |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1407911332
- Provider Enumeration Date: 12/22/2006
- Last Update Date: 01/18/2023
Medicare PECOS Information:
- PECOS PAC ID: 8022052364
- Enrollment ID: I20050617000030
Medical Identifiers
Medical identifiers for Ms Tina Celeste Outlaw such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1407911332 | NPI | - | NPPES |
| SW1208 | Medicaid | SC | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 1041C0700X | Social Worker - Clinical | 5160 (South 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. Ms Tina Celeste Outlaw allows following entities to bill medicare on her behalf.
| Entity Name | Palmetto Counseling & Consulting Services Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1487805529
PECOS PAC ID: 2365592797
Enrollment ID: O20090605000435 |
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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. Ms Tina Celeste Outlaw 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 |
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Ms Tina Celeste Outlaw, BSW,MSW, LISW-CP
2919 Jeffords Rd,
Lamar, SC 29069-9494
Ph: (843) 713-6205 | Ms Tina Celeste Outlaw, BSW,MSW, LISW-CP
2919 Jeffords Rd N, Outlaw's Vision Quest Farm, Inc.,
Lamar, SC 29069-9494
Ph: (843) 857-0298 |
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