Shelly M Self, LPC in Ardmore, OK - Medicare Counselor Provider

Shelly M Self, LPC is a medicare enrolled "Counselor - Mental Health" provider in Ardmore, Oklahoma. Her current practice location is 301 W Main St, Ste 324, Ardmore, Oklahoma. You can reach out to her office (for appointments etc.) via phone at (580) 238-0506.

Shelly M Self is licensed to practice in * (Not Available) (license number ) 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 1265706428.

Contact Information

	Shelly M Self, LPC
	301 W Main St, Ste 324, Ardmore, OK 73401-6337
	(580) 238-0506
	(580) 238-0506

Map and Direction

Healthcare Provider's Profile

Full Name	Shelly M Self
Gender	Female
Speciality	Counselor - Mental Health
Location	301 W Main St, Ardmore, Oklahoma
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1265706428
Provider Enumeration Date: 03/05/2012
Last Update Date: 10/09/2015

Medicare PECOS Information:

PECOS PAC ID: 7012455710
Enrollment ID: I20240813001590

Medical Identifiers

Medical identifiers for Shelly M Self such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1265706428	NPI	-	NPPES
200049040C	Medicaid	OK

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
101YM0800X	Counselor - Mental Health	(* (Not Available))	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. Shelly M Self allows following entities to bill medicare on her behalf.

Entity Name	Lynch Family Services Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1568722379 PECOS PAC ID: 0446584205 Enrollment ID: O20190627001776

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 M Self 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
Shelly M Self, LPC 704 Shirley Ln, Madill, OK 73446-9772 Ph: (580) 238-0506	Shelly M Self, LPC 301 W Main St, Ste 324, Ardmore, OK 73401-6337 Ph: (580) 238-0506

Reviews and Comments

Counselor in Ardmore, OK

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Nathan Smith, Counselor Medicare: Not Enrolled in Medicare Practice Location: 2530 S Commerce St Bldg C, Ardmore, OK 73401 Phone: 580-226-5048 Fax: 580-226-3569

Shelly M Self, LPC - Medicare Counselor in Ardmore, OK