Lesley Self Ford, LPC in Fordyce, AR - Medicare Counselor Provider

Lesley Self Ford, LPC is a medicare enrolled "Counselor - Mental Health" provider in Fordyce, Arkansas. Her current practice location is 201 N Clifton St, Fordyce, Arkansas. You can reach out to her office (for appointments etc.) via phone at (870) 352-6311.

Lesley Self Ford is licensed to practice in Arkansas (license number A1808119) 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 1134259443.

Contact Information

	Lesley Self Ford, LPC
	201 N Clifton St, Fordyce, AR 71742-3026
	(870) 352-6311
	(870) 352-0223

Map and Direction

Healthcare Provider's Profile

Full Name	Lesley Self Ford
Gender	Female
Speciality	Counselor - Mental Health
Location	201 N Clifton St, Fordyce, Arkansas
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1134259443
Provider Enumeration Date: 03/06/2007
Last Update Date: 01/26/2024

Medicare PECOS Information:

PECOS PAC ID: 1951758606
Enrollment ID: I20231117000440

Medical Identifiers

Medical identifiers for Lesley Self Ford such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1134259443	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
101YM0800X	Counselor - Mental Health	A1808119 (Arkansas)	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. Lesley Self Ford allows following entities to bill medicare on her behalf.

Entity Name	Board Of Governors Of Dallas County Medical Center
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1043308935 PECOS PAC ID: 7416869300 Enrollment ID: O20040302000815

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. Lesley Self Ford 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
Lesley Self Ford, LPC Po Box 115, Ivan, AR 71748-0115 Ph: (501) 837-5773	Lesley Self Ford, LPC 201 N Clifton St, Fordyce, AR 71742-3026 Ph: (870) 352-6311

Reviews and Comments

Counselor in Fordyce, AR

Judy Prince, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 300 N Clifton St, Fordyce, AR 71742 Phone: 870-352-5122 Fax: 870-352-5127
Brandy Tydingco, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 300 N Clifton St, Fordyce, AR 71742 Phone: 870-352-5122 Fax: 870-352-5127
Frankie Hickman, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 300 N Clifton St, Fordyce, AR 71742 Phone: 870-352-5122 Fax: 870-352-5127
Jeanna Pennington, LPC Counselor Medicare: Medicare Enrolled Practice Location: 300 N Clifton St, Fordyce, AR 71742 Phone: 870-352-5122 Fax: 870-352-5127
Tracy Ann Pefferkorn, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 403 Filmore St., Fordyce, AR 71742 Phone: 870-313-1579 Fax: 870-352-5127
Mrs. Roselle Roberson, M.S., L.P.C. Counselor Medicare: Not Enrolled in Medicare Practice Location: 1101 W 3rd St, Fordyce, AR 71742 Phone: 870-352-5122 Fax: 870-352-5127

Lesley Self Ford, LPC - Medicare Counselor in Fordyce, AR