Mrs Holly Michelle Jordan, MSW, LICSW, AADC is a medicare enrolled "Social Worker - Clinical" provider in Scott Depot, West Virginia. Her current practice location is
97 Great Teays Blvd Ste 6, Scott Depot, West Virginia. You can reach out to her office (for appointments etc.) via phone at
(304) 757-6999.
Mrs Holly Michelle Jordan is licensed to practice in West Virginia (license number DP00943969) 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 1013229327.
Healthcare Provider's Profile
| Full Name | Mrs Holly Michelle Jordan |
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| Gender | Female |
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| Speciality | Social Worker - Clinical |
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| Location | 97 Great Teays Blvd Ste 6, Scott Depot, West 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: 1013229327
- Provider Enumeration Date: 07/02/2010
- Last Update Date: 08/02/2019
Medicare PECOS Information:
- PECOS PAC ID: 3173770732
- Enrollment ID: I20140213001112
Medical Identifiers
Medical identifiers for Mrs Holly Michelle Jordan such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1013229327 | NPI | - | NPPES |
| 1013229327 | Medicaid | WV | |
| 3810023874 | Medicaid | WV | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 1648 (North Carolina) | Secondary |
| 1041C0700X | Social Worker - Clinical | DP00943969 (West 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. Mrs Holly Michelle Jordan allows following entities to bill medicare on her behalf.
| Entity Name | Womencare Inc |
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| Entity Type | Part B Supplier - Public Health/welfare Agency |
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| Entity Identifiers | NPI Number: 1740450089
PECOS PAC ID: 4587568134
Enrollment ID: O20080807000128 |
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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 Holly Michelle Jordan 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 Holly Michelle Jordan, MSW, LICSW, AADC
97 Great Teays Blvd Ste 6,
Scott Depot, WV 25560-9816
Ph: (304) 757-6999 | Mrs Holly Michelle Jordan, MSW, LICSW, AADC
97 Great Teays Blvd Ste 6,
Scott Depot, WV 25560-9816
Ph: (304) 757-6999 |
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