Maurice Shane Etter, LCSW, CSAC is a medicare enrolled "Social Worker - Clinical" provider in Roanoke, Virginia. His current practice location is
504 23rd St Nw, Roanoke, Virginia. You can reach out to his office (for appointments etc.) via phone at
(540) 345-2606.
Maurice Shane Etter is licensed to practice in Virginia (license number 0904009951) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1053821884.
Healthcare Provider's Profile
| Full Name | Maurice Shane Etter |
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| Gender | Male |
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| Speciality | Social Worker - Clinical |
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| Location | 504 23rd St Nw, Roanoke, Virginia |
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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: 1053821884
- Provider Enumeration Date: 10/06/2017
- Last Update Date: 06/23/2023
Medicare PECOS Information:
- PECOS PAC ID: 8527325000
- Enrollment ID: I20171208002124
Medical Identifiers
Medical identifiers for Maurice Shane Etter such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1053821884 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Secondary |
| 1041C0700X | Social Worker - Clinical | 1053821884 (Virginia) | Secondary |
| 1041C0700X | Social Worker - Clinical | 0904009951 (Virginia) | 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. Maurice Shane Etter allows following entities to bill medicare on his behalf.
| Entity Name | Cccs & Associates Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1124542949
PECOS PAC ID: 4183073513
Enrollment ID: O20231212000066 |
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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. Maurice Shane Etter 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 |
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Maurice Shane Etter, LCSW, CSAC
2328 Peters Creek Rd Nw Ste 102,
Roanoke, VA 24017-1621
Ph: (540) 345-2606 | Maurice Shane Etter, LCSW, CSAC
504 23rd St Nw,
Roanoke, VA 24017-5414
Ph: (540) 345-2606 |
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