Mrs Kelly Jean Hollingsworth, LPCC in Fairmont, MN

Mrs Kelly Jean Hollingsworth, LPCC is a medicare enrolled "Counselor - Mental Health" provider in Fairmont, Minnesota. Her current practice location is 1244 Albion Ave, Fairmont, Minnesota. You can reach out to her office (for appointments etc.) via phone at (507) 236-7568.

Mrs Kelly Jean Hollingsworth is licensed to practice in Minnesota (license number 3275) 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 1073255774.

Contact Information

	Mrs Kelly Jean Hollingsworth, LPCC
	1244 Albion Ave, Fairmont, MN 56031-3139
	(507) 236-7568
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Mrs Kelly Jean Hollingsworth
Gender	Female
Speciality	Counselor - Mental Health
Location	1244 Albion Ave, Fairmont, Minnesota
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1073255774
Provider Enumeration Date: 04/12/2022
Last Update Date: 04/12/2022

Medicare PECOS Information:

PECOS PAC ID: 0941645097
Enrollment ID: I20240228001614

Medical Identifiers

Medical identifiers for Mrs Kelly Jean Hollingsworth such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1073255774	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
101YM0800X	Counselor - Mental Health	3275 (Minnesota)	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 Kelly Jean Hollingsworth allows following entities to bill medicare on her behalf.

Entity Name	Southwestern Mental Health Center Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1487654562 PECOS PAC ID: 7012816812 Enrollment ID: O20031231000148

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 Kelly Jean Hollingsworth 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 Kelly Jean Hollingsworth, LPCC 1244 Albion Ave, Fairmont, MN 56031-3139 Ph: (507) 236-7568	Mrs Kelly Jean Hollingsworth, LPCC 1244 Albion Ave, Fairmont, MN 56031-3139 Ph: (507) 236-7568

Reviews and Comments

Counselor in Fairmont, MN

Nicole Marie Behrens, M.S.,LPCC Counselor Medicare: Not Enrolled in Medicare Practice Location: 1420 N State St, Fairmont, MN 56031 Phone: 507-235-6070 Fax: 855-847-9876
Mrs. Jenny Marie Schwieger, LPCC Counselor Medicare: Not Enrolled in Medicare Practice Location: 816 E. Blue Earth Ave., Suite 8, Fairmont, MN 56031 Phone: 507-375-5688 Fax: 507-414-8185
Stefanie Janet Jaquette, Counselor Medicare: Not Enrolled in Medicare Practice Location: 117 Downtown Plz, Fairmont, MN 56031 Phone: 507-399-2149 Fax: 507-399-2159
Mr. David Robert Rynders, L.I.C.S.W. Counselor Medicare: Not Enrolled in Medicare Practice Location: 301 Downtown Plaza, #3, Fairmont, MN 56031 Phone: 507-735-8112 Fax: 507-235-8110
Maurice Lee Shoen, Counselor Medicare: Accepting Medicare Assignments Practice Location: 115 West First St, Fairmont, MN 56031 Phone: 507-238-4757 Fax: 507-238-1574
Miss Laura Emily Dekok, MS,LPCC Counselor Medicare: Medicare Enrolled Practice Location: 1420 N State St, Fairmont, MN 56031 Phone: 507-235-6070 Fax: 855-847-9876

Mrs Kelly Jean Hollingsworth, LPCC - Medicare Counselor in Fairmont, MN