Olivia Ann Goforth, LCSW in Bristol, CT - Medicare Social Worker Provider

Olivia Ann Goforth, LCSW is a medicare enrolled "Social Worker - Clinical" provider in Bristol, Connecticut. Her current practice location is 49 Renee St, Bristol, Connecticut. You can reach out to her office (for appointments etc.) via phone at (203) 726-6811.

Olivia Ann Goforth is licensed to practice in Connecticut (license number 10636) 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 1871009563.

Contact Information

	Olivia Ann Goforth, LCSW
	49 Renee St, Bristol, CT 06010-5580
	(203) 726-6811
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Olivia Ann Goforth
Gender	Female
Speciality	Social Worker - Clinical
Location	49 Renee St, Bristol, Connecticut
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1871009563
Provider Enumeration Date: 12/18/2017
Last Update Date: 03/01/2024

Medicare PECOS Information:

PECOS PAC ID: 4981934734
Enrollment ID: I20190923000832

Medical Identifiers

Medical identifiers for Olivia Ann Goforth such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1871009563	NPI	-	NPPES
008089787	Medicaid	CT

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
1041C0700X	Social Worker - Clinical	10636 (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. Olivia Ann Goforth allows following entities to bill medicare on her behalf.

Entity Name	Cornell Scott Hill Health Corporation
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1902921380 PECOS PAC ID: 3072418359 Enrollment ID: O20031201000145

Entity Name	State Of Connecticut
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1841225489 PECOS PAC ID: 8022915677 Enrollment ID: O20040319000427

Entity Name	Peaceful Mind Behavioral Health & Wellness Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1255926358 PECOS PAC ID: 0941683056 Enrollment ID: O20220822002310

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. Olivia Ann Goforth 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
Olivia Ann Goforth, LCSW 49 Renee St, Bristol, CT 06010-5580 Ph: (203) 726-6811	Olivia Ann Goforth, LCSW 49 Renee St, Bristol, CT 06010-5580 Ph: (203) 726-6811

Reviews and Comments

Social Worker in Bristol, CT

Amy Marie Boccaccio, L.C.S.W. Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 81 N Main St, Bristol, CT 06010 Phone: 860-583-9954 Fax: 860-585-6811
Kimberly Childs, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 85 Beleden Gardens Dr, Bristol, CT 06010 Phone: 860-845-5901
Linda Rich, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 100 Alba Dr, Bristol, CT 06010 Phone: 860-302-8055
Alexandra Martone, LCSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 225 N Main St Ste 106, Bristol, CT 06010 Phone: 860-793-3500
Mikyle Depina, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 43 Prospect St., Bristol, CT 06010 Phone: 860-797-4110
Emma Lockwood, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 43 Prospect St, Bristol, CT 06010 Phone: 860-584-2105
Donyale M Pina, LCSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 440 N Main St # D, Bristol, CT 06010 Phone: 860-314-2052 Fax: 860-314-2054

Olivia Ann Goforth, LCSW - Medicare Clinical Social Worker in Bristol, CT