Nicole Kristina Dozsa, LCSW, LCADCA is a medicare enrolled "Social Worker - Clinical" provider in Louisville, Kentucky. Her current practice location is
9720 Park Plaza Ave Unit 104, Louisville, Kentucky. You can reach out to her office (for appointments etc.) via phone at
(502) 938-0511.
Nicole Kristina Dozsa is licensed to practice in Kentucky (license number 255389) 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 1700496569.
Healthcare Provider's Profile
| Full Name | Nicole Kristina Dozsa |
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| Gender | Female |
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| Speciality | Social Worker - Clinical |
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| Location | 9720 Park Plaza Ave Unit 104, Louisville, Kentucky |
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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: 1700496569
- Provider Enumeration Date: 08/06/2020
- Last Update Date: 03/30/2021
Medicare PECOS Information:
- PECOS PAC ID: 0648679365
- Enrollment ID: I20210601001307
Medical Identifiers
Medical identifiers for Nicole Kristina Dozsa such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1700496569 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 263297 (Kentucky) | Secondary |
| 1041C0700X | Social Worker - Clinical | 255389 (Kentucky) | 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. Nicole Kristina Dozsa allows following entities to bill medicare on her behalf.
| Entity Name | Cleanse Clinic, Psc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1659726628
PECOS PAC ID: 1759630320
Enrollment ID: O20191118002369 |
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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. Nicole Kristina Dozsa 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 |
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Nicole Kristina Dozsa, LCSW, LCADCA
720 W Broadway Ste 202,
Louisville, KY 40202-3245
Ph: (502) 561-0943 | Nicole Kristina Dozsa, LCSW, LCADCA
9720 Park Plaza Ave Unit 104,
Louisville, KY 40241-2289
Ph: (502) 938-0511 |
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