Mrs Ketevan Gagnidze-mccormick, LMHC in Newburgh, NY

Mrs Ketevan Gagnidze-mccormick, LMHC is a medicare enrolled "Counselor - Mental Health" provider in Newburgh, New York. Her current practice location is 10 Bruce St, Newburgh, New York. You can reach out to her office (for appointments etc.) via phone at (845) 561-7284.

Mrs Ketevan Gagnidze-mccormick is licensed to practice in New York (license number 003123) 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 1356661037.

Contact Information

	Mrs Ketevan Gagnidze-mccormick, LMHC
	10 Bruce St, Newburgh, NY 12550-6602
	(845) 561-7284
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Mrs Ketevan Gagnidze-mccormick
Gender	Female
Speciality	Counselor - Mental Health
Location	10 Bruce St, Newburgh, New York
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1356661037
Provider Enumeration Date: 06/04/2010
Last Update Date: 06/04/2010

Medicare PECOS Information:

PECOS PAC ID: 3870035025
Enrollment ID: I20240604001947

Medical Identifiers

Medical identifiers for Mrs Ketevan Gagnidze-mccormick such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1356661037	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
101YM0800X	Counselor - Mental Health	003123 (New York)	Primary
101YP2500X	Counselor - Professional	37PC00314800 (New Jersey)	Secondary
104100000X	Social Worker	44SW05190800 (New Jersey)	Secondary

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 Ketevan Gagnidze-mccormick allows following entities to bill medicare on her behalf.

Entity Name	Wendy Keller, Lcsw, Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1982992889 PECOS PAC ID: 7810169646 Enrollment ID: O20111020000186

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 Ketevan Gagnidze-mccormick 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 Ketevan Gagnidze-mccormick, LMHC 10 Bruce St, Newburgh, NY 12550-6602 Ph: (845) 561-7284	Mrs Ketevan Gagnidze-mccormick, LMHC 10 Bruce St, Newburgh, NY 12550-6602 Ph: (845) 561-7284

Reviews and Comments

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Mrs Ketevan Gagnidze-mccormick, LMHC - Medicare Counselor in Newburgh, NY