Shante Mormon, LCSW, C-DBT, CGP in Little Rock, AR - Medicare Social Worker Provider

Shante Mormon, LCSW, C-DBT, CGP is a medicare enrolled "Social Worker - Clinical" provider in Little Rock, Arkansas. Her current practice location is 400 W Capitol Ave Ste 1700, Little Rock, Arkansas. You can reach out to her office (for appointments etc.) via phone at (501) 209-7522.

Shante Mormon is licensed to practice in Arkansas (license number 5030-C) 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 1932823358.

Contact Information

	Shante Mormon, LCSW, C-DBT, CGP
	400 W Capitol Ave Ste 1700, Little Rock, AR 72201-3438
	(501) 209-7522
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Shante Mormon
Gender	Female
Speciality	Social Worker - Clinical
Location	400 W Capitol Ave Ste 1700, Little Rock, Arkansas
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1932823358
Provider Enumeration Date: 09/29/2022
Last Update Date: 09/12/2024

Medicare PECOS Information:

PECOS PAC ID: 4688030638
Enrollment ID: I20230516003684

Medical Identifiers

Medical identifiers for Shante Mormon such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1932823358	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
1041C0700X	Social Worker - Clinical	5030-C (Arkansas)	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. Shante Mormon allows following entities to bill medicare on her behalf.

Entity Name	Thrive Counseling Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1215181300 PECOS PAC ID: 0749458420 Enrollment ID: O20210330001195

Entity Name	Supportive Psych Care Of Arkansas Pa
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1437887437 PECOS PAC ID: 8820474661 Enrollment ID: O20221003001887

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. Shante Mormon 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
Shante Mormon, LCSW, C-DBT, CGP Po Box 1283, Benton, AR 72018-1283 Ph: (501) 209-7522	Shante Mormon, LCSW, C-DBT, CGP 400 W Capitol Ave Ste 1700, Little Rock, AR 72201-3438 Ph: (501) 209-7522

Reviews and Comments

Social Worker in Little Rock, AR

Ann Richardson Wrotny, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 10800 Financial Centre Pkwy, Suite 490, Little Rock, AR 72211 Phone: 501-228-0288 Fax: 501-228-8189
Ms. Sabrina Louesa Blevins, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 900 S Shackleford Rd Ste 300, Little Rock, AR 72211 Phone: 501-765-3266 Fax: 501-716-2530
Michael D Lowery, LCSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 4224 Shuffield Dr, Little Rock, AR 72205 Phone: 501-526-8200 Fax: 501-526-5296
Diana Smith, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 11 Childrens Way # 401, Little Rock, AR 72202 Phone: 501-364-3813
Mrs. Elizabeth Pullam New, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1605 Kavanaugh Blvd, Little Rock, AR 72205 Phone: 501-247-5416
Mr. John C. Knott, LCSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 600 S Mckinley St, Suite 400, Little Rock, AR 72205 Phone: 501-663-4673
Mr. Joseph Boatwright, MSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 11028 Yosemite Valley Dr, Little Rock, AR 72212 Phone: 501-225-8092 Fax: 501-325-1711

Shante Mormon, LCSW, C-DBT, CGP - Medicare Clinical Social Worker in Little Rock, AR