Kiersten Misra, MSW, LISW-S, LICDC is a medicare enrolled "Social Worker - Clinical" provider in Toledo, Ohio. Her current practice location is
3131 Executive Pkwy Ste 205, Toledo, Ohio. You can reach out to her office (for appointments etc.) via phone at
(419) 360-7026.
Kiersten Misra is licensed to practice in Ohio (license number I.1801351-SUPV) 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 1780137950.
Healthcare Provider's Profile
| Full Name | Kiersten Misra |
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| Gender | Female |
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| Speciality | Social Worker - Clinical |
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| Location | 3131 Executive Pkwy Ste 205, Toledo, Ohio |
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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: 1780137950
- Provider Enumeration Date: 07/25/2016
- Last Update Date: 01/26/2023
Medicare PECOS Information:
- PECOS PAC ID: 6507191921
- Enrollment ID: I20190708002142
Medical Identifiers
Medical identifiers for Kiersten Misra such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1780137950 | NPI | - | NPPES |
| 0360500 | Medicaid | OH | |
| 1972140044 | Other | OH | NPI II |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | LICDC.161602 (Ohio) | Secondary |
| 1041C0700X | Social Worker - Clinical | I.1801351-SUPV (Ohio) | 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. Kiersten Misra allows following entities to bill medicare on her behalf.
| Entity Name | Sylvania Community Counseling Services Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1972140044
PECOS PAC ID: 1355776212
Enrollment ID: O20200122003405 |
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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. Kiersten Misra 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 |
|---|
Kiersten Misra, MSW, LISW-S, LICDC
3131 Executive Pkwy Ste 205,
Toledo, OH 43606-1327
Ph: (419) 360-7026 | Kiersten Misra, MSW, LISW-S, LICDC
3131 Executive Pkwy Ste 205,
Toledo, OH 43606-1327
Ph: (419) 360-7026 |
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