Mr Thomas W Hazen, CMHC in Provo, UT - Medicare Counselor Provider

Mr Thomas W Hazen, CMHC is a medicare enrolled "Counselor - Mental Health" provider in Provo, Utah. His current practice location is 1300 E Center St, Provo, Utah. You can reach out to his office (for appointments etc.) via phone at (801) 344-4400.

Mr Thomas W Hazen is licensed to practice in Utah (license number 139747-6004) 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 1083785240.

Contact Information

	Mr Thomas W Hazen, CMHC
	1300 E Center St, Provo, UT 84606-3554
	(801) 344-4400
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Mr Thomas W Hazen
Gender	Male
Speciality	Counselor - Mental Health
Location	1300 E Center St, Provo, Utah
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1083785240
Provider Enumeration Date: 11/10/2006
Last Update Date: 05/29/2024

Medicare PECOS Information:

PECOS PAC ID: 2264873561
Enrollment ID: I20240517001918

Medical Identifiers

Medical identifiers for Mr Thomas W Hazen such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1083785240	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
101YM0800X	Counselor - Mental Health	139747-6004 (Utah)	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 Thomas W Hazen allows following entities to bill medicare on his behalf.

Entity Name	State Of Utah
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1811978620 PECOS PAC ID: 6800797333 Enrollment ID: O20040117000195

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 Thomas W Hazen 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 Thomas W Hazen, CMHC 1175 E 100 N, Suite 206, Payson, UT 84651-1665 Ph: (801) 592-4040	Mr Thomas W Hazen, CMHC 1300 E Center St, Provo, UT 84606-3554 Ph: (801) 344-4400

Reviews and Comments

Counselor in Provo, UT

Susan Easton Black, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1190 N 900 E, Provo, UT 84604 Phone: 801-422-7620 Fax: 801-422-0165
Daniel Howell, Counselor Medicare: Not Enrolled in Medicare Practice Location: 619 N 500 W, Provo, UT 84601 Phone: 801-375-4240 Fax: 801-375-4241
Vicki Goodman, Counselor Medicare: Not Enrolled in Medicare Practice Location: 619 N 500 W, Provo, UT 84601 Phone: 801-420-0465 Fax: 801-375-4241
Colbey Bentley, Counselor Medicare: Not Enrolled in Medicare Practice Location: 717 N 1850 W, Provo, UT 84604 Phone: 801-375-4240 Fax: 801-375-4241
Maurhy Alfredo Meneses, Counselor Medicare: Not Enrolled in Medicare Practice Location: 836 N 1375 W, Provo, UT 84604 Phone: 801-375-2523 Fax: 801-375-2523
David Skiles, CMHC Counselor Medicare: Medicare Enrolled Practice Location: 750 N Freedom Blvd, Provo, UT 84601 Phone: 801-373-4760 Fax: 801-373-0639
Scott D Owen, PH.D. Counselor Medicare: Not Enrolled in Medicare Practice Location: 3651 N 100 E Ste 100, Provo, UT 84604 Phone: 801-356-0014 Fax: 801-373-3655

Mr Thomas W Hazen, CMHC - Medicare Counselor in Provo, UT