Shane Williamson, MS in Deltona, FL - Medicare Counselor Provider

Shane Williamson, MS is a medicare enrolled "Counselor - Mental Health" provider in Deltona, Florida. His current practice location is 1604 Pendleton St, Deltona, Florida. You can reach out to his office (for appointments etc.) via phone at (407) 402-4777.

Shane Williamson is licensed to practice in Florida (license number MH20135) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1356890693.

Contact Information

	Shane Williamson, MS
	1604 Pendleton St, Deltona, FL 32725-7548
	(407) 402-4777
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Shane Williamson
Gender	Male
Speciality	Counselor - Mental Health
Location	1604 Pendleton St, Deltona, Florida
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1356890693
Provider Enumeration Date: 09/28/2016
Last Update Date: 10/28/2022

Medicare PECOS Information:

PECOS PAC ID: 1153770342
Enrollment ID: I20231213002454

Medical Identifiers

Medical identifiers for Shane Williamson such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1356890693	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
101YM0800X	Counselor - Mental Health	MH20135 (Florida)	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. Shane Williamson allows following entities to bill medicare on his behalf.

Entity Name	Personal Recovery Network Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1881990869 PECOS PAC ID: 5092611384 Enrollment ID: O20200416000590

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. Shane Williamson 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
Shane Williamson, MS 1604 Pendleton St, Deltona, FL 32725-7548 Ph: (407) 402-4777	Shane Williamson, MS 1604 Pendleton St, Deltona, FL 32725-7548 Ph: (407) 402-4777

Reviews and Comments

Counselor in Deltona, FL

Mr. John Joseph Ciotti Jr., RMHCI Counselor Medicare: Not Enrolled in Medicare Practice Location: 517 Deltona Blvd Ste A, Deltona, FL 32725 Phone: 386-259-5413
Brittany Marie Davis, LMHC, NCC Counselor Medicare: Medicare Enrolled Practice Location: 1025 Portland St, Deltona, FL 32725 Phone: 636-541-6515
Yvonne Kuhn, Counselor Medicare: Not Enrolled in Medicare Practice Location: 517 Deltona Blvd, Ste A, Deltona, FL 32725 Phone: 386-259-5413
Ms. Lavelle L. Jenkins, MA, MBA Counselor Medicare: Not Enrolled in Medicare Practice Location: 2494 Shiprock Ct, Deltona, FL 32738 Phone: 407-831-2411 Fax: 407-831-0195
Mrs. Simone Yvette Bethea, MA Counselor Medicare: Not Enrolled in Medicare Practice Location: 517 Deltona Blvd, Deltona, FL 32725 Phone: 386-473-4566
Mildred Wilks O'neill White, LMHC Counselor Medicare: Not Enrolled in Medicare Practice Location: 1324 Hartley Ave, Deltona, FL 32725 Phone: 386-626-8369
Arelis Acevedo, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1800 Gatewood Dr, Deltona, FL 32738 Phone: 787-240-5511

Shane Williamson, MS - Medicare Counselor in Deltona, FL