Kristine Marie Thackrey, LISW, LICDC is a medicare enrolled "Social Worker - Clinical" provider in Lima, Ohio. She graduated from healthcare school in 1990 and has 34 years of diverse experience with area of expertise as Clinical Social Worker. She is a member of the group practice Dakota Professional Corp and her current practice location is
3611 S Dixie Hwy, Lima, Ohio. You can reach out to her office (for appointments etc.) via phone at
(419) 999-2024.
Kristine Marie Thackrey is licensed to practice in Ohio (license number I5522) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1497819916.
Healthcare Provider's Profile
| Full Name | Kristine Marie Thackrey |
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| Gender | Female |
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| Speciality | Clinical Social Worker |
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| Experience | 34 Years |
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| Location | 3611 S Dixie Hwy, Lima, Ohio |
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| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Kristine Marie Thackrey graduated from medical school in 1990
NPI Data:
- NPI Number: 1497819916
- Provider Enumeration Date: 12/20/2006
- Last Update Date: 07/08/2007
Medicare PECOS Information:
- PECOS PAC ID: 8426152513
- Enrollment ID: I20070329000374
Medical Identifiers
Medical identifiers for Kristine Marie Thackrey such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1497819916 | NPI | - | NPPES |
| 000000352379 | Other | OH | ANTHEM BLUE CROSS AND BLU |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 933608 (Ohio) | Primary |
| 1041C0700X | Social Worker - Clinical | I5522 (Ohio) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| Dakota Professional Corp | 6800810904 | 2 |
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. Kristine Marie Thackrey allows following entities to bill medicare on her behalf.
| Entity Name | Dakota Professional Corp |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1083667828
PECOS PAC ID: 6800810904
Enrollment ID: O20060117000171 |
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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. Kristine Marie Thackrey 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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Kristine Marie Thackrey, LISW, LICDC
3611 S Dixie Hwy,
Lima, OH 45804-3750
Ph: (419) 999-2024 | Kristine Marie Thackrey, LISW, LICDC
3611 S Dixie Hwy,
Lima, OH 45804-3750
Ph: (419) 999-2024 |
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