Sara N Jettawi, LPC in Kenosha, WI - Medicare Counselor Provider

Sara N Jettawi, LPC is a medicare enrolled "Counselor" provider in Kenosha, Wisconsin. Her current practice location is 2108 63rd St, Kenosha, Wisconsin. You can reach out to her office (for appointments etc.) via phone at (262) 652-2406.

Sara N Jettawi is licensed to practice in Wisconsin (license number 10456-125) 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 1447912480.

Contact Information

	Sara N Jettawi, LPC
	2108 63rd St, Kenosha, WI 53143-4454
	(262) 652-2406
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Sara N Jettawi
Gender	Female
Speciality	Counselor
Location	2108 63rd St, Kenosha, Wisconsin
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1447912480
Provider Enumeration Date: 10/07/2021
Last Update Date: 06/04/2024

Medicare PECOS Information:

PECOS PAC ID: 2567806250
Enrollment ID: I20240221002602

Medical Identifiers

Medical identifiers for Sara N Jettawi such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1447912480	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
101YP2500X	Counselor - Professional	10456-125 (Wisconsin)	Secondary
104100000X	Social Worker	5035-226 (Wisconsin)	Secondary
101Y00000X	Counselor	10456-125 (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. Sara N Jettawi allows following entities to bill medicare on her behalf.

Entity Name	Professional Services Group Inc.
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1619024262 PECOS PAC ID: 8224296454 Enrollment ID: O20120220000742

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. Sara N Jettawi 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
Sara N Jettawi, LPC 6233 39th Ave, Kenosha, WI 53142-7015 Ph: (262) 654-1004	Sara N Jettawi, LPC 2108 63rd St, Kenosha, WI 53143-4454 Ph: (262) 652-2406

Reviews and Comments

Counselor in Kenosha, WI

La Shanda Tolefree, BA, MS Counselor Medicare: Medicare Enrolled Practice Location: 3536 52nd St, Kenosha, WI 53144 Phone: 262-842-0538 Fax: 262-842-0539
Ann M Grossman, MS, LPC-IT Counselor Medicare: Not Enrolled in Medicare Practice Location: 6321 23rd Ave, Kenosha, WI 53143 Phone: 414-455-3879 Fax: 866-719-3024
Stephanie L Mayberry, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 6127 Green Bay Rd Ste 200, Kenosha, WI 53142 Phone: 262-654-8366 Fax: 262-842-0444
Jami Lynn Pomeroy, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 1400 75th St, Kenosha, WI 53143 Phone: 262-909-6008
Kathleen M Bullard, MS, LPC-IT, SAC-IT Counselor Medicare: Not Enrolled in Medicare Practice Location: 4003 80th St Ste 101, Kenosha, WI 53142 Phone: 262-806-1467 Fax: 262-661-7702
Monica Christian, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 2108 63rd St, Kenosha, WI 53143 Phone: 262-652-2406
Jessica Martzahl, LPC Counselor Medicare: Medicare Enrolled Practice Location: 2108 63rd St, Kenosha, WI 53143 Phone: 262-652-2406

Sara N Jettawi, LPC - Medicare Counselor in Kenosha, WI