Mrs Erica Petree, LCSW is a medicare enrolled "Social Worker - Clinical" provider in Johnson City, Tennessee. Her current practice location is
207 N Boone St Ste 102, Johnson City, Tennessee. You can reach out to her office (for appointments etc.) via phone at
(619) 839-9730.
Mrs Erica Petree is licensed to practice in Tennessee (license number 7666) 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 1275506255.
Healthcare Provider's Profile
| Full Name | Mrs Erica Petree |
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| Gender | Female |
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| Speciality | Social Worker - Clinical |
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| Location | 207 N Boone St Ste 102, Johnson City, Tennessee |
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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: 1275506255
- Provider Enumeration Date: 02/09/2006
- Last Update Date: 02/20/2024
Medicare PECOS Information:
- PECOS PAC ID: 3678967783
- Enrollment ID: I20220304001741
Medical Identifiers
Medical identifiers for Mrs Erica Petree such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1275506255 | NPI | - | NPPES |
| 091740301 | Medicaid | TX | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YM0800X | Counselor - Mental Health | 60460 (California) | Secondary |
| 104100000X | Social Worker | 41439 (Texas) | Secondary |
| 1041C0700X | Social Worker - Clinical | 7666 (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. Mrs Erica Petree allows following entities to bill medicare on her behalf.
| Entity Name | East Tennessee State University |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1093990608
PECOS PAC ID: 2769394774
Enrollment ID: O20031212000403 |
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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. Mrs Erica Petree 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 |
|---|
Mrs Erica Petree, LCSW
207 N Boone St Ste 102,
Johnson City, TN 37604-5675
Ph: (619) 839-9730 | Mrs Erica Petree, LCSW
207 N Boone St Ste 102,
Johnson City, TN 37604-5675
Ph: (619) 839-9730 |
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