Kathleen Wakefield, LMSW-ACP is a medicare enrolled "Social Worker - Clinical" provider in Tyler, Texas. Her current practice location is
2323 W Front St, Tyler, Texas. You can reach out to her office (for appointments etc.) via phone at
(903) 597-1351.
Kathleen Wakefield is licensed to practice in Texas (license number 22205) 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 1063481380.
Healthcare Provider's Profile
| Full Name | Kathleen Wakefield |
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| Gender | Female |
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| Speciality | Social Worker - Clinical |
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| Location | 2323 W Front St, Tyler, Texas |
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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: 1063481380
- Provider Enumeration Date: 03/17/2006
- Last Update Date: 01/04/2024
Medicare PECOS Information:
- PECOS PAC ID: 1153395934
- Enrollment ID: I20040826000077
Medical Identifiers
Medical identifiers for Kathleen Wakefield such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1063481380 | NPI | - | NPPES |
| 169604901 | Medicaid | TX | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 101YM0800X | Counselor - Mental Health | 22205 (Texas) | Secondary |
| 1041C0700X | Social Worker - Clinical | 22205 (Texas) | 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. Kathleen Wakefield allows following entities to bill medicare on her behalf.
| Entity Name | Andrews Center |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1821064742
PECOS PAC ID: 9739170770
Enrollment ID: O20040519001179 |
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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. Kathleen Wakefield 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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Kathleen Wakefield, LMSW-ACP
Po Box 4730,
Tyler, TX 75712-4730
Ph: (903) 535-7355 | Kathleen Wakefield, LMSW-ACP
2323 W Front St,
Tyler, TX 75702-7704
Ph: (903) 597-1351 |
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