Shelly A Gallenberg, PHD is a medicare enrolled "Psychologist" provider in Antigo, Wisconsin. She graduated from healthcare school in 2009 and has 16 years of diverse experience with area of expertise as Clinical Psychologist. She is a member of the group practice The Lakes Community Health Center Inc and her current practice location is
1225 Langlade Rd, Antigo, Wisconsin. You can reach out to her office (for appointments etc.) via phone at
(715) 627-6694.
Shelly A Gallenberg is licensed to practice in Wisconsin (license number 3111) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1821313859.
Healthcare Provider's Profile
| Full Name | Shelly A Gallenberg |
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| Gender | Female |
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| Speciality | Clinical Psychologist |
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| Experience | 16 Years |
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| Location | 1225 Langlade Rd, Antigo, Wisconsin |
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| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Shelly A Gallenberg graduated from medical school in 2009
NPI Data:
- NPI Number: 1821313859
- Provider Enumeration Date: 04/01/2010
- Last Update Date: 02/03/2014
Medicare PECOS Information:
- PECOS PAC ID: 8224272315
- Enrollment ID: I20130911000121
Medical Identifiers
Medical identifiers for Shelly A Gallenberg such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1821313859 | NPI | - | NPPES |
| 4293-125 | Other | WI | STATE LICENSE |
| 3111 | Other | WI | STATE LICENSE |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YP2500X | Counselor - Professional | 4293-125 (Wisconsin) | Secondary |
| 103T00000X | Psychologist | 3111 (Wisconsin) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| The Lakes Community Health Center Inc | 0840366654 | 67 |
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. Shelly A Gallenberg allows following entities to bill medicare on her behalf.
| Entity Name | The Lakes Community Health Center Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1811178825
PECOS PAC ID: 0840366654
Enrollment ID: O20101019000186 |
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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. Shelly A Gallenberg 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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Shelly A Gallenberg, PHD
1100 Lake View Dr,
Wausau, WI 54403-6785
Ph: (715) 848-4600 | Shelly A Gallenberg, PHD
1225 Langlade Rd,
Antigo, WI 54409-2762
Ph: (715) 627-6694 |
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