Marissa Lee Douglas, LMHC in Brockport, NY - Medicare Counselor Provider

Marissa Lee Douglas, LMHC is a medicare enrolled "Counselor - Mental Health" provider in Brockport, New York. Her current practice location is 300 West Ave, Brockport, New York. You can reach out to her office (for appointments etc.) via phone at (585) 637-3905.

Marissa Lee Douglas is licensed to practice in New York (license number 011838-01) 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 1417600982.

Contact Information

	Marissa Lee Douglas, LMHC
	300 West Ave, Brockport, NY 14420-1118
	(585) 637-3905
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Marissa Lee Douglas
Gender	Female
Speciality	Counselor - Mental Health
Location	300 West Ave, Brockport, New York
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1417600982
Provider Enumeration Date: 02/03/2022
Last Update Date: 02/03/2022

Medicare PECOS Information:

PECOS PAC ID: 6507219169
Enrollment ID: I20240130003362

Medical Identifiers

Medical identifiers for Marissa Lee Douglas such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1417600982	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
101YM0800X	Counselor - Mental Health	011838-01 (New York)	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. Marissa Lee Douglas allows following entities to bill medicare on her behalf.

Entity Name	Oak Orchard Community Health Center, Inc.
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1598707812 PECOS PAC ID: 5496746927 Enrollment ID: O20040521001124

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. Marissa Lee Douglas 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
Marissa Lee Douglas, LMHC 1042 Clarkson Parma Tl Rd, Hilton, NY 14468-9709 Ph: (585) 749-3274	Marissa Lee Douglas, LMHC 300 West Ave, Brockport, NY 14420-1118 Ph: (585) 637-3905

Reviews and Comments

Counselor in Brockport, NY

Erich Montfort, Counselor Medicare: Not Enrolled in Medicare Practice Location: 8055 W Canal Rd, Brockport, NY 14420 Phone: 585-353-2150
Ms. Barbara K Shulla, LMHC, LMFT Counselor Medicare: Not Enrolled in Medicare Practice Location: 3148 Lake Rd N, Brockport, NY 14420 Phone: 585-314-0357
Erwin Mckenzie, Counselor Medicare: Not Enrolled in Medicare Practice Location: 193 Calebs Trl, Brockport, NY 14420 Phone: 940-337-5693
Mrs. Samantha Elaine Golden, LMHC, NCC, CCTP Counselor Medicare: Medicare Enrolled Practice Location: 13 Water St Ste 3, Brockport, NY 14420 Phone: 585-590-4463
Dr. Tamara Sullivan, LMHC Counselor Medicare: Not Enrolled in Medicare Practice Location: 4107 Lake Rd N, Brockport, NY 14420 Phone: 585-329-7853
Hayley Mandel, Counselor Medicare: Medicare Enrolled Practice Location: 300 West Ave Ste 900, Brockport, NY 14420 Phone: 585-637-3905 Fax: 585-637-2375

Marissa Lee Douglas, LMHC - Medicare Counselor in Brockport, NY