Stefanie Leann Kissick, LCSW is a medicare enrolled "Social Worker - Clinical" provider in Carrollton, Missouri. Her current practice location is
1502 N Jefferson St, Carrollton, Missouri. You can reach out to her office (for appointments etc.) via phone at
(660) 542-1695.
Stefanie Leann Kissick is licensed to practice in Missouri (license number 2020003749) 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 1811766173.
Healthcare Provider's Profile
Full Name | Stefanie Leann Kissick |
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Gender | Female |
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Speciality | Social Worker - Clinical |
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Location | 1502 N Jefferson St, Carrollton, Missouri |
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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: 1811766173
- Provider Enumeration Date: 12/28/2023
- Last Update Date: 12/28/2023
Medicare PECOS Information:
- PECOS PAC ID: 5395197099
- Enrollment ID: I20240118001362
Medical Identifiers
Medical identifiers for Stefanie Leann Kissick such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1811766173 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
1041C0700X | Social Worker - Clinical | 2020003749 (Missouri) | 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. Stefanie Leann Kissick allows following entities to bill medicare on her behalf.
Entity Name | Carroll County Memorial Hospital |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1528067113 PECOS PAC ID: 2860485638 Enrollment ID: O20040407000120 |
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Entity Name | Jefferson Medical Group |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1215030713 PECOS PAC ID: 6800894379 Enrollment ID: O20061116000198 |
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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. Stefanie Leann Kissick 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 |
Stefanie Leann Kissick, LCSW 1502 N Jefferson St, Carrollton, MO 64633-1948 Ph: (660) 542-1695 | Stefanie Leann Kissick, LCSW 1502 N Jefferson St, Carrollton, MO 64633-1948 Ph: (660) 542-1695 |
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