Raven Wilson, in Plattsburgh, NY - Medicare Counselor Provider

Raven Wilson, is a medicare enrolled "Counselor - Mental Health" provider in Plattsburgh, New York. Her current practice location is 80 Sharron Ave, Plattsburgh, New York. You can reach out to her office (for appointments etc.) via phone at (518) 561-1447.

Raven Wilson is licensed to practice in New York (license number 010789) 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 1740725050.

Contact Information

	Raven Wilson,
	80 Sharron Ave, Plattsburgh, NY 12901-4700
	(518) 561-1447
	(518) 562-8812

Map and Direction

Healthcare Provider's Profile

Full Name	Raven Wilson
Gender	Female
Speciality	Counselor - Mental Health
Location	80 Sharron Ave, Plattsburgh, New York
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1740725050
Provider Enumeration Date: 12/21/2016
Last Update Date: 01/12/2021

Medicare PECOS Information:

PECOS PAC ID: 9436502507
Enrollment ID: I20240125002047

Medical Identifiers

Medical identifiers for Raven Wilson such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1740725050	NPI	-	NPPES
01420800	Medicaid	NY

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
101YM0800X	Counselor - Mental Health	010789 (New York)	Primary
101YA0400X	Counselor - Addiction (substance Use Disorder)	33417 (New York)	Secondary

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. Raven Wilson allows following entities to bill medicare on her behalf.

Entity Name	Conifer Park Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1356396543 PECOS PAC ID: 2769470384 Enrollment ID: O20040503001584

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. Raven Wilson 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
Raven Wilson, 79 Glenridge Rd, Glenville, NY 12302-4523 Ph: (518) 952-8408	Raven Wilson, 80 Sharron Ave, Plattsburgh, NY 12901-4700 Ph: (518) 561-1447

Reviews and Comments

Counselor in Plattsburgh, NY

Katrina Lopez, Counselor Medicare: Not Enrolled in Medicare Practice Location: 80 Sharron Ave, Plattsburgh, NY 12901 Phone: 518-561-1447
Dr. Michele Marie Carpentier, LMHC Counselor Medicare: Not Enrolled in Medicare Practice Location: 16 Baltimore Way, Plattsburgh, NY 12903 Phone: 518-563-7371
Jared Croy, CIT Counselor Medicare: Not Enrolled in Medicare Practice Location: 80 Sharron Ave, Plattsburgh, NY 12901 Phone: 518-561-1447 Fax: 518-562-8812
Sarah Olivia Yancey, LMHC Counselor Medicare: Not Enrolled in Medicare Practice Location: 22 Us Oval Ste 218, Plattsburgh, NY 12903 Phone: 518-563-8000
Skylar Hunyadi, LMHC Counselor Medicare: Medicare Enrolled Practice Location: 8 Broad St, Plattsburgh, NY 12901 Phone: 518-825-1555 Fax: 518-825-1550
Patrick Mccormick, CASC-T Counselor Medicare: Not Enrolled in Medicare Practice Location: 80 Sharron Ave, Plattsburgh, NY 12901 Phone: 518-561-1447
Mary Ellen Baughman, Counselor Medicare: Not Enrolled in Medicare Practice Location: 18 Ampersand Dr, Plattsburgh, NY 12901 Phone: 518-565-4020 Fax: 518-562-2783

Raven Wilson, - Medicare Counselor in Plattsburgh, NY