Jenise Elaine Tidd, LICDC-CS in Dayton, OH - Medicare Counselor Provider

Jenise Elaine Tidd, LICDC-CS is a medicare enrolled "Counselor - Addiction (substance Use Disorder)" provider in Dayton, Ohio. Her current practice location is 865 S Patterson Blvd, Dayton, Ohio. You can reach out to her office (for appointments etc.) via phone at (937) 966-4673.

Jenise Elaine Tidd is licensed to practice in Ohio (license number LICDC.161533) 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 1447765821.

Contact Information

	Jenise Elaine Tidd, LICDC-CS
	865 S Patterson Blvd, Dayton, OH 45402-2624
	(937) 966-4673
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Jenise Elaine Tidd
Gender	Female
Speciality	Counselor - Addiction (substance Use Disorder)
Location	865 S Patterson Blvd, Dayton, Ohio
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1447765821
Provider Enumeration Date: 12/07/2017
Last Update Date: 02/16/2024

Medicare PECOS Information:

PECOS PAC ID: 0244570299
Enrollment ID: I20240314004029

Medical Identifiers

Medical identifiers for Jenise Elaine Tidd such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1447765821	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
101YA0400X	Counselor - Addiction (substance Use Disorder)	161533 (Ohio)	Secondary
101YA0400X	Counselor - Addiction (substance Use Disorder)	LICDC.161533 (Ohio)	Primary
101YA0400X	Counselor - Addiction (substance Use Disorder)	(* (Not Available))	Secondary

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. Jenise Elaine Tidd allows following entities to bill medicare on her behalf.

Entity Name	Decoach Team Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1366992224 PECOS PAC ID: 7517244551 Enrollment ID: O20170501001472

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. Jenise Elaine Tidd 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
Jenise Elaine Tidd, LICDC-CS 100 Crowne Point Pl, Cincinnati, OH 45241-5427 Ph: (513) 743-7628	Jenise Elaine Tidd, LICDC-CS 865 S Patterson Blvd, Dayton, OH 45402-2624 Ph: (937) 966-4673

Reviews and Comments

Counselor in Dayton, OH

Jane M Winch, Counselor Medicare: Not Enrolled in Medicare Practice Location: 601 S Edwin C Moses Blvd, Fourth Floor Nw Building, Dayton, OH 45408 Phone: 937-276-8333 Fax: 937-276-8339
Mrs. Darcie Rupert Clark, MS, LPCC, LCDCIII Counselor Medicare: Medicare Enrolled Practice Location: 11 W Monument Ave Ste 100, Dayton, OH 45402 Phone: 937-679-6301 Fax: 937-630-4391
Amy Michelle Monteith, LPCC Counselor Medicare: Not Enrolled in Medicare Practice Location: 1 Childrens Plz, Dayton, OH 45404 Phone: 937-641-3401 Fax: 937-641-3046
Ashley H Hicks, PC Counselor Medicare: Not Enrolled in Medicare Practice Location: 601 S Edwin C Moses Blvd, 4th Floor, Nw Bldg., Dayton, OH 45417 Phone: 937-734-8333 Fax: 937-276-8269
Shea Kvachuk, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 1020 Woodman Dr Ste 330, Dayton, OH 45432 Phone: 937-253-0606
Quanice Locke, LCDCII Counselor Medicare: Not Enrolled in Medicare Practice Location: 4977 Northcutt Pl, Dayton, OH 45414 Phone: 937-450-7790
Sarah Byram, LPC Counselor Medicare: Medicare Enrolled Practice Location: 601 S Edwin C Moses Blvd, 4th Floor Nw Building, Dayton, OH 45417 Phone: 937-734-8333

Jenise Elaine Tidd, LICDC-CS - Medicare Counselor in Dayton, OH