Shockie M Dersno, LPC in Phoenix, AZ - Medicare Counselor Provider

Shockie M Dersno, LPC is a medicare enrolled "Counselor - Mental Health" provider in Phoenix, Arizona. Her current practice location is 1840 N 95th Ave Ste 146, Phoenix, Arizona. You can reach out to her office (for appointments etc.) via phone at (404) 953-2501.

Shockie M Dersno is licensed to practice in Arizona (license number LPC-18672) 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 1154961464.

Contact Information

	Shockie M Dersno, LPC
	1840 N 95th Ave Ste 146, Phoenix, AZ 85037-4446
	(404) 953-2501
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Shockie M Dersno
Gender	Female
Speciality	Counselor - Mental Health
Location	1840 N 95th Ave Ste 146, Phoenix, Arizona
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1154961464
Provider Enumeration Date: 01/14/2020
Last Update Date: 01/28/2020

Medicare PECOS Information:

PECOS PAC ID: 9032554878
Enrollment ID: I20240301003529

Medical Identifiers

Medical identifiers for Shockie M Dersno such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1154961464	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
101YM0800X	Counselor - Mental Health	LPC-18672 (Arizona)	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. Shockie M Dersno allows following entities to bill medicare on her behalf.

Entity Name	Neighborhood Outreach Access To Health
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1942518550 PECOS PAC ID: 3577743764 Enrollment ID: O20110204000504

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. Shockie M Dersno 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
Shockie M Dersno, LPC 1840 N 95th Ave Ste 146, Phoenix, AZ 85037-4446 Ph: (623) 234-9828	Shockie M Dersno, LPC 1840 N 95th Ave Ste 146, Phoenix, AZ 85037-4446 Ph: (404) 953-2501

Reviews and Comments

Counselor in Phoenix, AZ

Ms. Martha White, Counselor Medicare: Not Enrolled in Medicare Practice Location: 3306 W Catalina Dr, Phoenix, AZ 85017 Phone: 602-353-0703 Fax: 602-353-0715
Philip Lee Mcdonald, LMSW Counselor Medicare: Not Enrolled in Medicare Practice Location: 1648 S 16th St, Phoenix, AZ 85034 Phone: 714-235-1970
Melinda Chapin, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 3640 W Osborn Rd, Phoenix, AZ 85019 Phone: 602-269-5300 Fax: 602-269-5380
Beverly Seyler, M.S. Counselor Medicare: Not Enrolled in Medicare Practice Location: 4525 E Saint Anne Ave, Phoenix, AZ 85042 Phone: 602-431-6685
Mrs. Virginia Joyce Gatson, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1110 E Mcdowell Rd, Phoenix, AZ 85006 Phone: 602-685-1940 Fax: 602-685-1944
Margaret Ann Beresford, MC, ATR-BC, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 4545 N. 36th Street, Suite 117, Phoenix, AZ 85018 Phone: 602-509-5771
Kevin Jessup, LAC Counselor Medicare: Not Enrolled in Medicare Practice Location: 4214 N 19th Pl, Phoenix, AZ 85016 Phone: 602-460-5350

Shockie M Dersno, LPC - Medicare Counselor in Phoenix, AZ