Ms Nikki Haynesworth, LPC in Phoenix, AZ - Medicare Counselor Provider

Ms Nikki Haynesworth, LPC is a medicare enrolled "Counselor - Professional" provider in Phoenix, Arizona. Her current practice location is 12621 N Tatum Blvd, #1629, Phoenix, Arizona. You can reach out to her office (for appointments etc.) via phone at (480) 269-2202.

Ms Nikki Haynesworth is licensed to practice in Arizona (license number LPC-21169) 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 1750864500.

Contact Information

	Ms Nikki Haynesworth, LPC
	12621 N Tatum Blvd, #1629, Phoenix, AZ 85032
	(480) 269-2202
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Ms Nikki Haynesworth
Gender	Female
Speciality	Counselor - Professional
Location	12621 N Tatum Blvd, Phoenix, Arizona
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1750864500
Provider Enumeration Date: 09/07/2018
Last Update Date: 02/01/2024

Medicare PECOS Information:

PECOS PAC ID: 0547604910
Enrollment ID: I20240214001545

Medical Identifiers

Medical identifiers for Ms Nikki Haynesworth such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1750864500	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
101YM0800X	Counselor - Mental Health	007895 (New York)	Secondary
101YP2500X	Counselor - Professional	LPC-21169 (Arizona)	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 Nikki Haynesworth allows following entities to bill medicare on her behalf.

Entity Name	El Rio Santa Cruz Neighborhood Health Center, Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1487602736 PECOS PAC ID: 6305739244 Enrollment ID: O20040205000098

Entity Name	Brightside Medical Pa
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1609335660 PECOS PAC ID: 3678948809 Enrollment ID: O20230425001219

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 Nikki Haynesworth 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 Nikki Haynesworth, LPC 12621 N Tatum Blvd, #1629, Phoenix, AZ 85032 Ph: (585) 353-6868	Ms Nikki Haynesworth, LPC 12621 N Tatum Blvd, #1629, Phoenix, AZ 85032 Ph: (480) 269-2202

Reviews and Comments

Counselor in Phoenix, AZ

Ms. Martha White, Counselor Medicare: Not Enrolled in Medicare Practice Location: 3306 W Catalina Dr, Phoenix, AZ 85017 Phone: 602-353-0703 Fax: 602-353-0715
Philip Lee Mcdonald, LMSW Counselor Medicare: Not Enrolled in Medicare Practice Location: 1648 S 16th St, Phoenix, AZ 85034 Phone: 714-235-1970
Melinda Chapin, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 3640 W Osborn Rd, Phoenix, AZ 85019 Phone: 602-269-5300 Fax: 602-269-5380
Beverly Seyler, M.S. Counselor Medicare: Not Enrolled in Medicare Practice Location: 4525 E Saint Anne Ave, Phoenix, AZ 85042 Phone: 602-431-6685
Mrs. Virginia Joyce Gatson, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1110 E Mcdowell Rd, Phoenix, AZ 85006 Phone: 602-685-1940 Fax: 602-685-1944
Margaret Ann Beresford, MC, ATR-BC, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 4545 N. 36th Street, Suite 117, Phoenix, AZ 85018 Phone: 602-509-5771
Kevin Jessup, LAC Counselor Medicare: Not Enrolled in Medicare Practice Location: 4214 N 19th Pl, Phoenix, AZ 85016 Phone: 602-460-5350

Ms Nikki Haynesworth, LPC - Medicare Counselor in Phoenix, AZ