Shadese Lisa Griffith-mcclellan, LCSW-A,MSW is a medicare enrolled "Social Worker - Clinical" provider in Mooresville, North Carolina. Her current practice location is
125 Overhill Dr Ste 105, Mooresville, North Carolina. You can reach out to her office (for appointments etc.) via phone at
(980) 430-9205.
Shadese Lisa Griffith-mcclellan is licensed to practice in North Carolina (license number P015291) 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 1104163625.
Healthcare Provider's Profile
| Full Name | Shadese Lisa Griffith-mcclellan |
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| Gender | Female |
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| Speciality | Social Worker - Clinical |
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| Location | 125 Overhill Dr Ste 105, Mooresville, North Carolina |
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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: 1104163625
- Provider Enumeration Date: 01/04/2013
- Last Update Date: 02/01/2021
Medicare PECOS Information:
- PECOS PAC ID: 3072953173
- Enrollment ID: I20240506001385
Medical Identifiers
Medical identifiers for Shadese Lisa Griffith-mcclellan such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1104163625 | NPI | - | NPPES |
| 1104163625 | Medicaid | NC | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | LCAS-A -21455 (North Carolina) | Secondary |
| 1041C0700X | Social Worker - Clinical | P015291 (North Carolina) | 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. Shadese Lisa Griffith-mcclellan allows following entities to bill medicare on her behalf.
| Entity Name | Daymark Recovery Services Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1558329243
PECOS PAC ID: 0547233975
Enrollment ID: O20040814000213 |
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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. Shadese Lisa Griffith-mcclellan 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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Shadese Lisa Griffith-mcclellan, LCSW-A,MSW
1033 Phillips Ln,
Statesville, NC 28625-4747
Ph: (646) 938-9097 | Shadese Lisa Griffith-mcclellan, LCSW-A,MSW
125 Overhill Dr Ste 105,
Mooresville, NC 28117-8232
Ph: (980) 430-9205 |
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