Elizabeth Mundy-hemmerich, MSW, LCSW, QMHP is a medicare enrolled "Social Worker - Clinical" provider in Kenosha, Wisconsin. Her current practice location is
2108 63rd St, Kenosha, Wisconsin. You can reach out to her office (for appointments etc.) via phone at
(262) 652-2406.
Elizabeth Mundy-hemmerich is licensed to practice in Wisconsin (license number 9207-123) 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 1386834075.
Healthcare Provider's Profile
| Full Name | Elizabeth Mundy-hemmerich |
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| Gender | Female |
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| Speciality | Social Worker - Clinical |
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| Location | 2108 63rd St, Kenosha, Wisconsin |
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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: 1386834075
- Provider Enumeration Date: 07/28/2007
- Last Update Date: 10/26/2021
Medicare PECOS Information:
- PECOS PAC ID: 2668795477
- Enrollment ID: I20191220000177
Medical Identifiers
Medical identifiers for Elizabeth Mundy-hemmerich such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1386834075 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 101Y00000X | Counselor | (* (Not Available)) | Secondary |
| 1041C0700X | Social Worker - Clinical | 149.013900 (Illinois) | Secondary |
| 1041C0700X | Social Worker - Clinical | 9207-123 (Wisconsin) | 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. Elizabeth Mundy-hemmerich allows following entities to bill medicare on her behalf.
| Entity Name | Child & Family Therapeutic Systems Sc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1922176395
PECOS PAC ID: 6002842549
Enrollment ID: O20050715000136 |
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| Entity Name | Professional Services Group Inc. |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1619024262
PECOS PAC ID: 8224296454
Enrollment ID: O20120220000742 |
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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. Elizabeth Mundy-hemmerich 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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Elizabeth Mundy-hemmerich, MSW, LCSW, QMHP
4100 Veterans Pkwy,
Mchenry, IL 60050-8350
Ph: (815) 385-6400 | Elizabeth Mundy-hemmerich, MSW, LCSW, QMHP
2108 63rd St,
Kenosha, WI 53143-4454
Ph: (262) 652-2406 |
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