Carol A Derucki, LMHC in Goshen, IN - Medicare Counselor Provider

Carol A Derucki, LMHC is a medicare enrolled "Counselor - Mental Health" provider in Goshen, Indiana. Her current practice location is 330 Lakeview Dr, Goshen, Indiana. You can reach out to her office (for appointments etc.) via phone at (574) 537-2652.

Carol A Derucki is licensed to practice in Indiana (license number 39002267A) 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 1831421668.

Contact Information

	Carol A Derucki, LMHC
	330 Lakeview Dr, Goshen, IN 46528-7000
	(574) 537-2652
	(574) 537-2652

Map and Direction

Healthcare Provider's Profile

Full Name	Carol A Derucki
Gender	Female
Speciality	Counselor - Mental Health
Location	330 Lakeview Dr, Goshen, Indiana
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1831421668
Provider Enumeration Date: 02/04/2010
Last Update Date: 01/30/2024

Medicare PECOS Information:

PECOS PAC ID: 9638527682
Enrollment ID: I20231130003236

Medical Identifiers

Medical identifiers for Carol A Derucki such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1831421668	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
101Y00000X	Counselor	(* (Not Available))	Secondary
101YM0800X	Counselor - Mental Health	39002267A (Indiana)	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. Carol A Derucki allows following entities to bill medicare on her behalf.

Entity Name	Oaklawn Psychiatric Center Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1598847212 PECOS PAC ID: 6002801065 Enrollment ID: O20040419000647

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. Carol A Derucki 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
Carol A Derucki, LMHC 330 Lakeview Dr, Goshen, IN 46528-7000 Ph: (574) 533-1234	Carol A Derucki, LMHC 330 Lakeview Dr, Goshen, IN 46528-7000 Ph: (574) 537-2652

Reviews and Comments

Counselor in Goshen, IN

Lavern D Raber, Counselor Medicare: Not Enrolled in Medicare Practice Location: 330 Lakeview Dr, Goshen, IN 46528 Phone: 574-533-1234 Fax: 574-537-2652
Mandy Moretti, MSW Counselor Medicare: Not Enrolled in Medicare Practice Location: 330 Lakeview Dr, Goshen, IN 46528 Phone: 574-533-1234 Fax: 574-537-2652
Charlene Koenig, MA Counselor Medicare: Not Enrolled in Medicare Practice Location: 330 Lakeview Dr, Goshen, IN 46528 Phone: 574-533-1234 Fax: 574-537-2652
Travis Silveus, MA Counselor Medicare: Not Enrolled in Medicare Practice Location: 330 Lakeview Dr, Goshen, IN 46528 Phone: 574-533-1234 Fax: 574-537-2652
Erin Brown, NCC Counselor Medicare: Not Enrolled in Medicare Practice Location: 330 Lakeview Dr, Goshen, IN 46528 Phone: 574-537-2680
Jill L Tartaglione, MA Counselor Medicare: Not Enrolled in Medicare Practice Location: 330 Lakeview Dr, Goshen, IN 46528 Phone: 574-533-1234 Fax: 574-537-2652
Orelia Daye, MSW Counselor Medicare: Not Enrolled in Medicare Practice Location: 330 Lakeview Dr, Goshen, IN 46528 Phone: 574-533-1234 Fax: 574-537-2652

Carol A Derucki, LMHC - Medicare Counselor in Goshen, IN