Lyndsy Marie Mirasola, LCSW is a medicare enrolled "Social Worker - Clinical" provider in Grass Valley, California. Her current practice location is
11291 Dray Coury, Grass Valley, California. You can reach out to her office (for appointments etc.) via phone at
(530) 205-3130.
Lyndsy Marie Mirasola is licensed to practice in California (license number ASW63657) 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 1053719138.
Healthcare Provider's Profile
Full Name | Lyndsy Marie Mirasola |
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Gender | Female |
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Speciality | Social Worker - Clinical |
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Location | 11291 Dray Coury, Grass Valley, California |
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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: 1053719138
- Provider Enumeration Date: 12/05/2014
- Last Update Date: 12/16/2022
Medicare PECOS Information:
- PECOS PAC ID: 9739419987
- Enrollment ID: I20231204001905
Medical Identifiers
Medical identifiers for Lyndsy Marie Mirasola such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1053719138 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
101Y00000X | Counselor | (* (Not Available)) | Secondary |
101YM0800X | Counselor - Mental Health | 63657 (California) | Secondary |
104100000X | Social Worker | ASW63657 (California) | Secondary |
1041C0700X | Social Worker - Clinical | ASW63657 (California) | 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. Lyndsy Marie Mirasola allows following entities to bill medicare on her behalf.
Entity Name | Mind Body Program Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1205084118 PECOS PAC ID: 4183756877 Enrollment ID: O20100715000508 |
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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. Lyndsy Marie Mirasola 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 |
Lyndsy Marie Mirasola, LCSW 101 W Mcknight Way, Grass Valley, CA 95949-9613 Ph: (530) 205-3130 | Lyndsy Marie Mirasola, LCSW 11291 Dray Coury, Grass Valley, CA 95945-9594 Ph: (530) 205-3130 |
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