Carl Street, LPC in Bristow, VA - Medicare Counselor Provider

Carl Street, LPC is a medicare enrolled "Counselor" provider in Bristow, Virginia. His current practice location is 11835 Hazel Circle Dr, Bristow, Virginia. You can reach out to his office (for appointments etc.) via phone at (703) 636-5100.

Carl Street is licensed to practice in Virginia (license number 0701005656) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1720450943.

Contact Information

	Carl Street, LPC
	11835 Hazel Circle Dr, Bristow, VA 20136-2180
	(703) 636-5100
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Carl Street
Gender	Male
Speciality	Counselor
Location	11835 Hazel Circle Dr, Bristow, Virginia
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1720450943
Provider Enumeration Date: 10/27/2015
Last Update Date: 10/27/2015

Medicare PECOS Information:

PECOS PAC ID: 2860831336
Enrollment ID: I20240416004133

Medical Identifiers

Medical identifiers for Carl Street such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1720450943	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
101Y00000X	Counselor	0701005656 (Virginia)	Primary
101YA0400X	Counselor - Addiction (substance Use Disorder)	0718000249 (Virginia)	Secondary

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. Carl Street allows following entities to bill medicare on his behalf.

Entity Name	Youth For Tomorrow New Life Center Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1316118292 PECOS PAC ID: 1951673227 Enrollment ID: O20170822000018

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. Carl Street 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
Carl Street, LPC 14488 Sharpshinned Dr, Gainesville, VA 20155-5837 Ph: (703) 753-7229	Carl Street, LPC 11835 Hazel Circle Dr, Bristow, VA 20136-2180 Ph: (703) 636-5100

Reviews and Comments

Counselor in Bristow, VA

Naglaa Boutros Moussa, LPC Counselor Medicare: Medicare Enrolled Practice Location: 13199 Guildtown Pl, Bristow, VA 20136 Phone: 972-880-3510
Natalia Becker, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 11835 Hazel Circle Dr, Bristow, VA 20136 Phone: 703-396-7263
Mr. Terry Robert Tinsley, LPC, LMFT, NCC CSOTP Counselor Medicare: Not Enrolled in Medicare Practice Location: 11835 Hazel Circle Dr, Bristow, VA 20136 Phone: 703-631-3360
Mrs. Naomi Britton, LPC Counselor Medicare: Medicare Enrolled Practice Location: 11835 Hazel Circle Dr, Bristow, VA 20136 Phone: 703-636-5105 Fax: 877-411-7387
Meagan A Caesar, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 11835 Hazel Circle Dr, Bristow, VA 20136 Phone: 703-396-7240
Kaitlyn Zupka, LPC, NCC Counselor Medicare: Not Enrolled in Medicare Practice Location: 11908 Waterton Lake Ln, Bristow, VA 20136 Phone: 631-875-3226
Katelyn E Clark, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 11835 Hazel Circle Dr, Bristow, VA 20136 Phone: 571-416-0537

Carl Street, LPC - Medicare Counselor in Bristow, VA