Cynthia Ann Rollo-carlson, LICSW, LCSW,LADC is a medicare enrolled "Social Worker - Clinical" provider in Bemidji, Minnesota. Her current practice location is
1426 Bemidji Ave N Ste 1, Bemidji, Minnesota. You can reach out to her office (for appointments etc.) via phone at
(218) 444-2233.
Cynthia Ann Rollo-carlson is licensed to practice in Minnesota (license number 11704) 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 1609450428.
Healthcare Provider's Profile
| Full Name | Cynthia Ann Rollo-carlson |
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| Gender | Female |
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| Speciality | Social Worker - Clinical |
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| Location | 1426 Bemidji Ave N Ste 1, Bemidji, Minnesota |
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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: 1609450428
- Provider Enumeration Date: 05/07/2021
- Last Update Date: 02/23/2023
Medicare PECOS Information:
- PECOS PAC ID: 0840663555
- Enrollment ID: I20230228001692
Medical Identifiers
Medical identifiers for Cynthia Ann Rollo-carlson such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1609450428 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 301020 (Minnesota) | Secondary |
| 1041C0700X | Social Worker - Clinical | LCSW-3911 (Hawaii) | Secondary |
| 1041C0700X | Social Worker - Clinical | 11704 (Minnesota) | 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. Cynthia Ann Rollo-carlson allows following entities to bill medicare on her behalf.
| Entity Name | Lake Country Associates, Inc. |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1104151588
PECOS PAC ID: 3779610472
Enrollment ID: O20100429000429 |
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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. Cynthia Ann Rollo-carlson 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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Cynthia Ann Rollo-carlson, LICSW, LCSW,LADC
7561 Front St Nw,
Walker, MN 56484-2003
Ph: (808) 345-3205 | Cynthia Ann Rollo-carlson, LICSW, LCSW,LADC
1426 Bemidji Ave N Ste 1,
Bemidji, MN 56601-3882
Ph: (218) 444-2233 |
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