Stacy Lynn Cannavino, LCSW is a medicare enrolled "Social Worker - Clinical" provider in Athens, Pennsylvania. Her current practice location is
104 Water St, Athens, Pennsylvania. You can reach out to her office (for appointments etc.) via phone at
(570) 423-0365.
Stacy Lynn Cannavino is licensed to practice in New York (license number 1779893) 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 1457724361.
Healthcare Provider's Profile
Full Name | Stacy Lynn Cannavino |
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Gender | Female |
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Speciality | Social Worker - Clinical |
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Location | 104 Water St, Athens, Pennsylvania |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1457724361
- Provider Enumeration Date: 11/02/2015
- Last Update Date: 08/26/2022
Medicare PECOS Information:
- PECOS PAC ID: 4688056567
- Enrollment ID: I20220809003176
Medical Identifiers
Medical identifiers for Stacy Lynn Cannavino such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1457724361 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
101Y00000X | Counselor | (* (Not Available)) | Secondary |
1041C0700X | Social Worker - Clinical | 1779893 (New York) | 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 Lynn Cannavino allows following entities to bill medicare on her behalf.
Entity Name | Tioga County |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1124099700 PECOS PAC ID: 6709786916 Enrollment ID: O20040113000343 |
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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 Lynn Cannavino 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 Lynn Cannavino, LCSW 104 Water St, Athens, PA 18810-1002 Ph: (570) 423-0365 | Stacy Lynn Cannavino, LCSW 104 Water St, Athens, PA 18810-1002 Ph: (570) 423-0365 |
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