Ms Kisha Wynnette Mickens, LPC is a medicare enrolled "Counselor - Professional" provider in West Point, Virginia. Her current practice location is
3210 Mattaponi Ave, West Point, Virginia. You can reach out to her office (for appointments etc.) via phone at
(804) 767-0973.
Ms Kisha Wynnette Mickens is licensed to practice in Virginia (license number 0701012722) 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 1447933973.
Healthcare Provider's Profile
Full Name | Ms Kisha Wynnette Mickens |
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Gender | Female |
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Speciality | Counselor - Professional |
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Location | 3210 Mattaponi Ave, West Point, Virginia |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1447933973
- Provider Enumeration Date: 08/10/2023
- Last Update Date: 08/10/2023
Medicare PECOS Information:
- PECOS PAC ID: 9133579014
- Enrollment ID: I20231219003047
Medical Identifiers
Medical identifiers for Ms Kisha Wynnette Mickens such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1447933973 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
101YP2500X | Counselor - Professional | 0701012722 (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. Ms Kisha Wynnette Mickens allows following entities to bill medicare on her behalf.
Entity Name | Colonial Behavioral Health |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1760565915 PECOS PAC ID: 7012010549 Enrollment ID: O20070716000744 |
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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. Ms Kisha Wynnette Mickens 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 |
Ms Kisha Wynnette Mickens, LPC 3210 Mattaponi Ave, West Point, VA 23181-9307 Ph: (804) 767-0973 | Ms Kisha Wynnette Mickens, LPC 3210 Mattaponi Ave, West Point, VA 23181-9307 Ph: (804) 767-0973 |
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