Mr Ray Jamaal Herndon, LCSW is a medicare enrolled "Social Worker - Clinical" provider in Colorado Springs, Colorado. His current practice location is
1400 E Boulder St, Colorado Springs, Colorado. You can reach out to his office (for appointments etc.) via phone at
(719) 365-7505.
Mr Ray Jamaal Herndon is licensed to practice in Colorado (license number CSW.09928508) 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 1760611636.
Healthcare Provider's Profile
Full Name | Mr Ray Jamaal Herndon |
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Gender | Male |
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Speciality | Social Worker - Clinical |
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Location | 1400 E Boulder St, Colorado Springs, Colorado |
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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: 1760611636
- Provider Enumeration Date: 07/13/2009
- Last Update Date: 12/28/2022
Medicare PECOS Information:
- PECOS PAC ID: 2567847031
- Enrollment ID: I20220920000586
Medical Identifiers
Medical identifiers for Mr Ray Jamaal Herndon such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1760611636 | NPI | - | NPPES |
7565A | Other | CA | OUTPATIENT MENTAL HEALTH |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
1041C0700X | Social Worker - Clinical | CSW.09928508 (Colorado) | 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. Mr Ray Jamaal Herndon allows following entities to bill medicare on his behalf.
Entity Name | Sondermind Provider Network Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1760854442 PECOS PAC ID: 9537572490 Enrollment ID: O20210113002826 |
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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. Mr Ray Jamaal Herndon 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 |
Mr Ray Jamaal Herndon, LCSW Po Box 15555, Colorado Springs, CO 80935-5555 Ph: (909) 912-5351 | Mr Ray Jamaal Herndon, LCSW 1400 E Boulder St, Colorado Springs, CO 80909-5533 Ph: (719) 365-7505 |
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