Debra Diane, LCSW is a medicare enrolled "Social Worker - Clinical" provider in Fort Lauderdale, Florida. She graduated from healthcare school in 2003 and has 21 years of diverse experience with area of expertise as Clinical Social Worker. She is a member of the group practice Blue Moon Senior Counseling and her current practice location is
2900 W Prospect Rd, Fort Lauderdale, Florida. You can reach out to her office (for appointments etc.) via phone at
(954) 731-5100.
Debra Diane is licensed to practice in Florida (license number SW10293) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1861757239.
Healthcare Provider's Profile
| Full Name | Debra Diane |
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| Gender | Female |
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| Speciality | Clinical Social Worker |
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| Experience | 21 Years |
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| Location | 2900 W Prospect Rd, Fort Lauderdale, Florida |
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| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Debra Diane graduated from medical school in 2003
NPI Data:
- NPI Number: 1861757239
- Provider Enumeration Date: 07/11/2012
- Last Update Date: 11/05/2020
Medicare PECOS Information:
- PECOS PAC ID: 8820376379
- Enrollment ID: I20161103001071
Medical Identifiers
Medical identifiers for Debra Diane such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1861757239 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 101YM0800X | Counselor - Mental Health | SW10293 (Florida) | Secondary |
| 1041C0700X | Social Worker - Clinical | SW10293 (Florida) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| Blue Moon Senior Counseling | 6103099759 | 21 |
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. Debra Diane allows following entities to bill medicare on her behalf.
| Entity Name | Blue Moon Senior Counseling |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1205129186
PECOS PAC ID: 6103099759
Enrollment ID: O20111027000391 |
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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. Debra Diane 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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Debra Diane, LCSW
4740 N State Road 7 Ste 201,
Lauderdale Lakes, FL 33319-5839
Ph: (954) 777-1617 | Debra Diane, LCSW
2900 W Prospect Rd,
Fort Lauderdale, FL 33309-2519
Ph: (954) 731-5100 |
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