Mrs Kelly Sheppard Pruitt, LCMHC in Winston Salem, NC

Mrs Kelly Sheppard Pruitt, LCMHC is a medicare enrolled "Counselor - Mental Health" provider in Winston Salem, North Carolina. Her current practice location is 1255 Creekshire Way Ste 270, Winston Salem, North Carolina. You can reach out to her office (for appointments etc.) via phone at (336) 283-4757.

Mrs Kelly Sheppard Pruitt is licensed to practice in North Carolina (license number 12644) 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 1962172916.

Contact Information

	Mrs Kelly Sheppard Pruitt, LCMHC
	1255 Creekshire Way Ste 270, Winston Salem, NC 27103-3061
	(336) 283-4757
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Mrs Kelly Sheppard Pruitt
Gender	Female
Speciality	Counselor - Mental Health
Location	1255 Creekshire Way Ste 270, Winston Salem, North Carolina
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1962172916
Provider Enumeration Date: 09/20/2021
Last Update Date: 09/20/2021

Medicare PECOS Information:

PECOS PAC ID: 5395183701
Enrollment ID: I20240404001598

Medical Identifiers

Medical identifiers for Mrs Kelly Sheppard Pruitt such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1962172916	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
101YM0800X	Counselor - Mental Health	12644 (North Carolina)	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 Sheppard Pruitt allows following entities to bill medicare on her behalf.

Entity Name	Animo Sano Psychiatry Pllc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1568043537 PECOS PAC ID: 8729489182 Enrollment ID: O20210623002788

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 Sheppard Pruitt 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 Sheppard Pruitt, LCMHC 709 Trillium Ln, Winston Salem, NC 27127-6072 Ph: () -	Mrs Kelly Sheppard Pruitt, LCMHC 1255 Creekshire Way Ste 270, Winston Salem, NC 27103-3061 Ph: (336) 283-4757

Reviews and Comments

Counselor in Winston Salem, NC

Timothy Carl Blake, Counselor Medicare: Not Enrolled in Medicare Practice Location: 725 Highland Ave, Winston Salem, NC 27101 Phone: 336-607-8523
Keren Happuch Williams, LCMHC Counselor Medicare: Medicare Enrolled Practice Location: 140 Kimel Park Dr Ste 200, Winston Salem, NC 27103 Phone: 336-718-7250 Fax: 336-718-7260
Amy Bowden, LCSWA Counselor Medicare: Accepting Medicare Assignments Practice Location: 665 W 4th St, Winston Salem, NC 27101 Phone: 336-725-8389 Fax: 336-725-6628
Chelsea Baldwin Rogers, Counselor Medicare: Not Enrolled in Medicare Practice Location: 7670 N Point Ct, Winston Salem, NC 27106 Phone: 855-362-8470 Fax: 704-362-8464
Mrs. Amy Kolb Shuman, LPC, NBCC Counselor Medicare: Not Enrolled in Medicare Practice Location: 640 Holly Ave, Winston Salem, NC 27101 Phone: 336-725-3999
Amanda Grace Connelly, Counselor Medicare: Medicare Enrolled Practice Location: 4140 Cherry St, Winston Salem, NC 27105 Phone: 336-306-9620
Lesa Arnold Chesson, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 4265 Brownsboro Rd, Suite 214, Winston Salem, NC 27106 Phone: 336-896-0022

Mrs Kelly Sheppard Pruitt, LCMHC - Medicare Counselor in Winston Salem, NC