Lydia Jean Haker, is a medicare enrolled "Psychologist - Clinical" provider in De Pere, Wisconsin. Her current practice location is
1118 Twilight Dr, De Pere, Wisconsin. You can reach out to her office (for appointments etc.) via phone at
(715) 966-3596.
Lydia Jean Haker is licensed to practice in Wisconsin (license number 5213-17) 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 1245759190.
Healthcare Provider's Profile
Full Name | Lydia Jean Haker |
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Gender | Female |
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Speciality | Psychologist - Clinical |
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Location | 1118 Twilight Dr, De Pere, Wisconsin |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1245759190
- Provider Enumeration Date: 09/12/2017
- Last Update Date: 06/12/2024
Medicare PECOS Information:
- PECOS PAC ID: 4688027600
- Enrollment ID: I20240125004639
Medical Identifiers
Medical identifiers for Lydia Jean Haker such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1245759190 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
101YP2500X | Counselor - Professional | 3537-226 (Wisconsin) | Secondary |
103TC0700X | Psychologist - Clinical | 5213-17 (Wisconsin) | 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. Lydia Jean Haker allows following entities to bill medicare on her behalf.
Entity Name | County Of Door-door County Library |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1245265693 PECOS PAC ID: 2062434194 Enrollment ID: O20060103000615 |
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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. Lydia Jean Haker 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 |
Lydia Jean Haker, 611 Butler St, De Pere, WI 54115-1203 Ph: () - | Lydia Jean Haker, 1118 Twilight Dr, De Pere, WI 54115-1372 Ph: (715) 966-3596 |
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