Mattie N Crockett, LPC, MHSP in Kingsport, TN

Mattie N Crockett, LPC, MHSP is a medicare enrolled "Counselor - Professional" provider in Kingsport, Tennessee. Her current practice location is 1536 Bridgewater Ln Ste 104, Kingsport, Tennessee. You can reach out to her office (for appointments etc.) via phone at (423) 534-7824.

Mattie N Crockett is licensed to practice in Tennessee (license number 4912) 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 1952975005.

Contact Information

	Mattie N Crockett, LPC, MHSP
	1536 Bridgewater Ln Ste 104, Kingsport, TN 37660-4103
	(423) 534-7824
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Mattie N Crockett
Gender	Female
Speciality	Counselor - Professional
Location	1536 Bridgewater Ln Ste 104, Kingsport, Tennessee
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1952975005
Provider Enumeration Date: 05/13/2021
Last Update Date: 08/14/2024

Medicare PECOS Information:

PECOS PAC ID: 5193168946
Enrollment ID: I20240208001505

Medical Identifiers

Medical identifiers for Mattie N Crockett such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1952975005	NPI	-	NPPES
4912	Other	TN	LPC-MHSP

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
101YP2500X	Counselor - Professional	4912 (Tennessee)	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. Mattie N Crockett allows following entities to bill medicare on her behalf.

Entity Name	Healthy Mind Counseling Services, Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1457409898 PECOS PAC ID: 8325093081 Enrollment ID: O20070827000096

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. Mattie N Crockett 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
Mattie N Crockett, LPC, MHSP 301 Larkspur Dr, Kingsport, TN 37660-6225 Ph: (276) 639-5676	Mattie N Crockett, LPC, MHSP 1536 Bridgewater Ln Ste 104, Kingsport, TN 37660-4103 Ph: (423) 534-7824

Reviews and Comments

Counselor in Kingsport, TN

Andrea Nicole Mccloud, MA, NCC Counselor Medicare: Not Enrolled in Medicare Practice Location: 605 Watauga St, Kingsport, TN 37660 Phone: 423-408-2601
Ms. Kristy Mae Tipton, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 1570 Waverly Rd, Kingsport, TN 37664 Phone: 423-224-1300 Fax: 423-224-1375
Debra Lavery Sensibaugh, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 2001 Stonebrook Pl, Kingsport, TN 37660 Phone: 423-224-1000
Joshua Paul Ledford, BS Counselor Medicare: Not Enrolled in Medicare Practice Location: 2001 Stonebrook Pl, Kingsport, TN 37660 Phone: 423-224-1000 Fax: 423-224-1023
Harold B Leonard, LPC Counselor Medicare: Medicare Enrolled Practice Location: 2300 Pavilion Dr, Kingsport, TN 37660 Phone: 423-857-5571 Fax: 423-857-5237
Rebecca Leigh Waldenstrom, MED Counselor Medicare: Not Enrolled in Medicare Practice Location: 2001 Stonebrook Pl, Kingsport, TN 37660 Phone: 423-224-1000 Fax: 423-224-1023
Kelly J Medlin, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 2001 E Stonebrook Pl, Kingsport, TN 37660 Phone: 423-224-1000 Fax: 423-467-3644

Mattie N Crockett, LPC, MHSP - Medicare Counselor in Kingsport, TN