Lisa A Withrow, MSSW, LCSW is a medicare enrolled "Social Worker - Clinical" provider in Evansville, Indiana. Her current practice location is
415 Mulberry St, Evansville, Indiana. You can reach out to her office (for appointments etc.) via phone at
(812) 473-3144.
Lisa A Withrow is licensed to practice in Indiana (license number 34003565A) 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 1669696050.
Healthcare Provider's Profile
| Full Name | Lisa A Withrow |
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| Gender | Female |
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| Speciality | Social Worker - Clinical |
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| Location | 415 Mulberry St, Evansville, Indiana |
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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: 1669696050
- Provider Enumeration Date: 04/13/2007
- Last Update Date: 08/27/2020
Medicare PECOS Information:
- PECOS PAC ID: 7012973456
- Enrollment ID: I20041207000763
Medical Identifiers
Medical identifiers for Lisa A Withrow such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1669696050 | NPI | - | NPPES |
| 100240880 | Medicaid | IN | |
| 000000 | Other | | ANTHEM |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Secondary |
| 1041C0700X | Social Worker - Clinical | 34003565A (Indiana) | 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. Lisa A Withrow allows following entities to bill medicare on her behalf.
| Entity Name | Southwestern Behavioral Healthcare, Inc. |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1033108766
PECOS PAC ID: 7315842309
Enrollment ID: O20031203000451 |
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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. Lisa A Withrow 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 |
|---|
Lisa A Withrow, MSSW, LCSW
415 Mulberry Street,
Evansville, IN 47713-1230
Ph: (812) 423-7791 | Lisa A Withrow, MSSW, LCSW
415 Mulberry St,
Evansville, IN 47713-1230
Ph: (812) 473-3144 |
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