Nichole Decorah, LPC-IT in Portage, WI - Medicare Counselor Provider

Nichole Decorah, LPC-IT is a medicare enrolled "Counselor - Professional" provider in Portage, Wisconsin. Her current practice location is 1508 New Pinery Rd, Portage, Wisconsin. You can reach out to her office (for appointments etc.) via phone at (608) 745-4900.

Nichole Decorah is licensed to practice in Wisconsin (license number 5176-226) 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 1154894848.

Contact Information

	Nichole Decorah, LPC-IT
	1508 New Pinery Rd, Portage, WI 53901-1312
	(608) 745-4900
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Nichole Decorah
Gender	Female
Speciality	Counselor - Professional
Location	1508 New Pinery Rd, Portage, Wisconsin
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1154894848
Provider Enumeration Date: 01/06/2019
Last Update Date: 08/21/2024

Medicare PECOS Information:

PECOS PAC ID: 1456890912
Enrollment ID: I20240828001602

Medical Identifiers

Medical identifiers for Nichole Decorah such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1154894848	NPI	-	NPPES
1154894848	Medicaid	WI

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
101YP2500X	Counselor - Professional	5176-226 (Wisconsin)	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. Nichole Decorah allows following entities to bill medicare on her behalf.

Entity Name	Dean Health Systems Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1053358846 PECOS PAC ID: 7012827983 Enrollment ID: O20031105000584

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. Nichole Decorah 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
Nichole Decorah, LPC-IT 532 Laurel St, Reedsburg, WI 53959-1231 Ph: (608) 566-5187	Nichole Decorah, LPC-IT 1508 New Pinery Rd, Portage, WI 53901-1312 Ph: (608) 745-4900

Reviews and Comments

Counselor in Portage, WI

Mrs. Heather Jane Gove, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 2639 New Pinery Rd # 1, Portage, WI 53901 Phone: 608-742-5020
Shaun Alexander Hardie, Counselor Medicare: Not Enrolled in Medicare Practice Location: 2639 New Pinery Rd Ste 1, Portage, WI 53901 Phone: 608-742-5020 Fax: 608-742-7011
Melissa Trago, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1508 New Pinery Rd, Portage, WI 53901 Phone: 608-745-4900
Robin A Deethardt, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 2901 Hunters Trl, Portage, WI 53901 Phone: 608-742-5518 Fax: 608-742-4087
Susan A Knower, LPC, IDPAT Counselor Medicare: Medicare Enrolled Practice Location: 2901 Hunters Trl, Portage, WI 53901 Phone: 608-742-5518 Fax: 608-742-4087
Sarah J Kravick, LMFT Counselor Medicare: Medicare Enrolled Practice Location: 2639 New Pinery Rd, Suite 1, Portage, WI 53901 Phone: 608-742-5020 Fax: 608-742-3641
Kristine G Schmitt, MA, LPC Counselor Medicare: Medicare Enrolled Practice Location: 2901 Hunters Trl, Portage, WI 53901 Phone: 608-742-5518

Nichole Decorah, LPC-IT - Medicare Counselor in Portage, WI