Stacy Nicole Luce, LCPC is a medicare enrolled "Counselor - Professional" provider in Kootenai, Idaho. Her current practice location is
404 Kootenai St, Kootenai, Idaho. You can reach out to her office (for appointments etc.) via phone at
(810) 845-4472.
Stacy Nicole Luce is licensed to practice in Idaho (license number LCPC-6335) 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 1114286358.
Healthcare Provider's Profile
| Full Name | Stacy Nicole Luce |
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| Gender | Female |
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| Speciality | Counselor - Professional |
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| Location | 404 Kootenai St, Kootenai, Idaho |
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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: 1114286358
- Provider Enumeration Date: 05/09/2012
- Last Update Date: 08/24/2020
Medicare PECOS Information:
- PECOS PAC ID: 4385095959
- Enrollment ID: I20240108004972
Medical Identifiers
Medical identifiers for Stacy Nicole Luce such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1114286358 | NPI | - | NPPES |
| 1114286358 | Medicaid | ID | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YM0800X | Counselor - Mental Health | LCPC-6335 (Idaho) | Secondary |
| 101YP2500X | Counselor - Professional | LCPC-6335 (Idaho) | 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. Stacy Nicole Luce allows following entities to bill medicare on her behalf.
| Entity Name | Boundary Regional Community Health Center, Inc. |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1538447727
PECOS PAC ID: 2264341221
Enrollment ID: O20050211000195 |
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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. Stacy Nicole Luce 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 |
|---|
Stacy Nicole Luce, LCPC
Po Box 203,
Kootenai, ID 83840-0203
Ph: (810) 845-4472 | Stacy Nicole Luce, LCPC
404 Kootenai St,
Kootenai, ID 83840-0276
Ph: (810) 845-4472 |
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