Ms Shannon Dannielle Goodwin, LMSW, AAPS is a medicare enrolled "Social Worker - Clinical" provider in Wichita, Kansas. Her current practice location is
2627 E Central Ave, Wichita, Kansas. You can reach out to her office (for appointments etc.) via phone at
(316) 684-5300.
Ms Shannon Dannielle Goodwin is licensed to practice in Kansas (license number 4137) 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 1386782746.
Healthcare Provider's Profile
| Full Name | Ms Shannon Dannielle Goodwin |
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| Gender | Female |
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| Speciality | Social Worker - Clinical |
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| Location | 2627 E Central Ave, Wichita, Kansas |
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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: 1386782746
- Provider Enumeration Date: 02/01/2007
- Last Update Date: 06/16/2020
Medicare PECOS Information:
- PECOS PAC ID: 3971750548
- Enrollment ID: I20120904000758
Medical Identifiers
Medical identifiers for Ms Shannon Dannielle Goodwin such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1386782746 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 619 (Kansas) | Secondary |
| 1041C0700X | Social Worker - Clinical | 4137 (Kansas) | 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 Shannon Dannielle Goodwin allows following entities to bill medicare on her behalf.
| Entity Name | Blue Moon Therapy, Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1205319472
PECOS PAC ID: 1052738770
Enrollment ID: O20200826002763 |
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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 Shannon Dannielle Goodwin 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 Shannon Dannielle Goodwin, LMSW, AAPS
1215 E Jump St,
Wichita, KS 67216-1360
Ph: (316) 304-3585 | Ms Shannon Dannielle Goodwin, LMSW, AAPS
2627 E Central Ave,
Wichita, KS 67214-4608
Ph: (316) 684-5300 |
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