Ms Jordan Ami Dalton, LCSW, LAC is a medicare enrolled "Social Worker - Clinical" provider in Dolores, Colorado. Her current practice location is
413 Central Ave Apt D, Dolores, Colorado. You can reach out to her office (for appointments etc.) via phone at
(719) 994-2808.
Ms Jordan Ami Dalton is licensed to practice in Colorado (license number CSW.09928551) 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 1689103657.
Healthcare Provider's Profile
| Full Name | Ms Jordan Ami Dalton |
|---|
| Gender | Female |
|---|
| Speciality | Social Worker - Clinical |
|---|
| Location | 413 Central Ave Apt D, Dolores, Colorado |
|---|
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
|---|
NPI Data:
- NPI Number: 1689103657
- Provider Enumeration Date: 06/05/2017
- Last Update Date: 11/07/2024
Medicare PECOS Information:
- PECOS PAC ID: 4789053851
- Enrollment ID: I20221212002349
Medical Identifiers
Medical identifiers for Ms Jordan Ami Dalton such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1689103657 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | ACD.0001934 (Colorado) | Secondary |
| 1041C0700X | Social Worker - Clinical | CSW.09928551 (Colorado) | 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. Ms Jordan Ami Dalton allows following entities to bill medicare on her behalf.
| Entity Name | Sondermind Provider Network Llc |
|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
|---|
| Entity Identifiers | NPI Number: 1760854442
PECOS PAC ID: 9537572490
Enrollment ID: O20210113002826 |
|---|
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. Ms Jordan Ami Dalton 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 |
|---|
Ms Jordan Ami Dalton, LCSW, LAC
Po Box 1105,
Dolores, CO 81323-1105
Ph: () - | Ms Jordan Ami Dalton, LCSW, LAC
413 Central Ave Apt D,
Dolores, CO 81323-8310
Ph: (719) 994-2808 |
Reviews and Comments