Tiffany Samuelson, LMSW, CADC is a medicare enrolled "Counselor - Addiction (substance Use Disorder)" provider in Sioux City, Iowa. Her current practice location is
1021 Nebraska St, Sioux City, Iowa. You can reach out to her office (for appointments etc.) via phone at
(122) 522-4777.
Tiffany Samuelson is licensed to practice in Iowa (license number 13042) 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 1083075006.
Healthcare Provider's Profile
| Full Name | Tiffany Samuelson |
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| Gender | Female |
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| Speciality | Counselor - Addiction (substance Use Disorder) |
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| Location | 1021 Nebraska St, Sioux City, Iowa |
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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: 1083075006
- Provider Enumeration Date: 03/18/2016
- Last Update Date: 10/30/2019
Medicare PECOS Information:
- PECOS PAC ID: 4880026848
- Enrollment ID: I20191112002461
Medical Identifiers
Medical identifiers for Tiffany Samuelson such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1083075006 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 1041C0700X | Social Worker - Clinical | 073276 (Iowa) | Secondary |
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 13042 (Iowa) | 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. Tiffany Samuelson allows following entities to bill medicare on her behalf.
| Entity Name | Siouxland Community Health Center |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1558355305
PECOS PAC ID: 9931099546
Enrollment ID: O20040317001270 |
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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. Tiffany Samuelson 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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Tiffany Samuelson, LMSW, CADC
3320 W 4th St,
Sioux City, IA 51103-3200
Ph: (712) 202-0777 | Tiffany Samuelson, LMSW, CADC
1021 Nebraska St,
Sioux City, IA 51105-1436
Ph: (122) 522-4777 |
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