Extasy Grinn, LCSW, CAP ICADC is a medicare enrolled "Social Worker" provider in Maryville, Tennessee. Her current practice location is
2030 Chilhowee Medical Park, Maryville, Tennessee. You can reach out to her office (for appointments etc.) via phone at
(865) 982-3400.
Extasy Grinn is licensed to practice in Tennessee (license number 7341) 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 1124534912.
Healthcare Provider's Profile
| Full Name | Extasy Grinn |
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| Gender | Female |
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| Speciality | Social Worker |
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| Location | 2030 Chilhowee Medical Park, Maryville, Tennessee |
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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: 1124534912
- Provider Enumeration Date: 12/16/2017
- Last Update Date: 10/08/2020
Medicare PECOS Information:
- PECOS PAC ID: 1951662527
- Enrollment ID: I20221209000468
Medical Identifiers
Medical identifiers for Extasy Grinn such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1124534912 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | ADC-003288-2014 (Florida) | Secondary |
| 1041C0700X | Social Worker - Clinical | SW14806 (Florida) | Secondary |
| 104100000X | Social Worker | 7341 (Tennessee) | 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. Extasy Grinn allows following entities to bill medicare on her behalf.
| Entity Name | Athena Consulting And Psychological Services, Pllc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1336292465
PECOS PAC ID: 5294719795
Enrollment ID: O20040614001008 |
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| Entity Name | Savida Health, Pc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1861118846
PECOS PAC ID: 4082809967
Enrollment ID: O20221228001386 |
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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. Extasy Grinn 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 |
|---|
Extasy Grinn, LCSW, CAP ICADC
4799 Palmbrooke Cir,
West Palm Beach, FL 33417-7534
Ph: (561) 876-8751 | Extasy Grinn, LCSW, CAP ICADC
2030 Chilhowee Medical Park,
Maryville, TN 37804-5285
Ph: (865) 982-3400 |
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