Kelsey Shannon Soles, is a medicare enrolled "Counselor - Mental Health" provider in Burke, South Dakota. Her current practice location is
841 Jackson St Ste C, Burke, South Dakota. You can reach out to her office (for appointments etc.) via phone at
(605) 494-1500.
Kelsey Shannon Soles is licensed to practice in South Dakota (license number LPC-MH30578) 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 1619520020.
Healthcare Provider's Profile
| Full Name | Kelsey Shannon Soles |
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| Gender | Female |
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| Speciality | Counselor - Mental Health |
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| Location | 841 Jackson St Ste C, Burke, South Dakota |
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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: 1619520020
- Provider Enumeration Date: 07/24/2019
- Last Update Date: 10/17/2024
Medicare PECOS Information:
- PECOS PAC ID: 9830624402
- Enrollment ID: I20241120001641
Medical Identifiers
Medical identifiers for Kelsey Shannon Soles such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1619520020 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 101YM0800X | Counselor - Mental Health | LPC20398 (South Dakota) | Secondary |
| 101YM0800X | Counselor - Mental Health | LPC-MH30578 (South Dakota) | 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. Kelsey Shannon Soles allows following entities to bill medicare on her behalf.
| Entity Name | Rising Hope Counseling, Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1780190967
PECOS PAC ID: 3274958640
Enrollment ID: O20200731001828 |
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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. Kelsey Shannon Soles 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 |
|---|
Kelsey Shannon Soles,
30863 301st St,
Winner, SD 57580-6216
Ph: (605) 208-4047 | Kelsey Shannon Soles,
841 Jackson St Ste C,
Burke, SD 57523-2065
Ph: (605) 494-1500 |
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