Stephanie Goodrum, LPC in Selmer, TN - Medicare Counselor Provider

Stephanie Goodrum, LPC is a medicare enrolled "Counselor - Mental Health" provider in Selmer, Tennessee. Her current practice location is 641 E Poplar Ave, Selmer, Tennessee. You can reach out to her office (for appointments etc.) via phone at (731) 645-5753.

Stephanie Goodrum is licensed to practice in Tennessee (license number LPC1677) 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 1972611788.

Contact Information

	Stephanie Goodrum, LPC
	641 E Poplar Ave, Selmer, TN 38375-1828
	(731) 645-5753
	(731) 645-9885

Map and Direction

Healthcare Provider's Profile

Full Name	Stephanie Goodrum
Gender	Female
Speciality	Counselor - Mental Health
Location	641 E Poplar Ave, Selmer, Tennessee
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1972611788
Provider Enumeration Date: 08/29/2006
Last Update Date: 02/19/2024

Medicare PECOS Information:

PECOS PAC ID: 4486002425
Enrollment ID: I20231130003064

Medical Identifiers

Medical identifiers for Stephanie Goodrum such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1972611788	NPI	-	NPPES
4099873	Other	TN	BCBS PROVIDER NUMBER
572994000	Medicaid	TN

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
101YP2500X	Counselor - Professional	LPC1677 (Tennessee)	Secondary
104100000X	Social Worker	LPC 1677 (Tennessee)	Secondary
101YM0800X	Counselor - Mental Health	LPC1677 (Tennessee)	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. Stephanie Goodrum allows following entities to bill medicare on her behalf.

Entity Name	Mental Health Centers & Clinics Of Tennessee
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1255442794 PECOS PAC ID: 3678475621 Enrollment ID: O20040121001005

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. Stephanie Goodrum 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
Stephanie Goodrum, LPC 3772 Highway 45 S, Selmer, TN 38375-6606 Ph: (731) 645-5753	Stephanie Goodrum, LPC 641 E Poplar Ave, Selmer, TN 38375-1828 Ph: (731) 645-5753

Reviews and Comments

Counselor in Selmer, TN

Janet Gaddis, MA Counselor Medicare: Medicare Enrolled Practice Location: 641 E Poplar Ave, Selmer, TN 38375 Phone: 731-645-5753 Fax: 731-645-9885
Jessica Sain, BS Counselor Medicare: Not Enrolled in Medicare Practice Location: 641 E Poplar Ave, Selmer, TN 38375 Phone: 731-645-5753 Fax: 731-645-9885
Tressel Ball, M.ED. Counselor Medicare: Not Enrolled in Medicare Practice Location: 641 E Poplar Ave, Selmer, TN 38375 Phone: 173-164-5575 Fax: 731-645-9885
Matthew Tyler Jernigan, Counselor Medicare: Not Enrolled in Medicare Practice Location: 641 E Poplar Ave, Selmer, TN 38375 Phone: 731-645-5753 Fax: 731-645-9885
Vanesssa K Warren, BSW Counselor Medicare: Not Enrolled in Medicare Practice Location: 641 E Poplar Ave, Selmer, TN 38375 Phone: 731-645-5753 Fax: 731-645-9885
Tami Buck, BA Counselor Medicare: Not Enrolled in Medicare Practice Location: 641 E Poplar Ave, Selmer, TN 38375 Phone: 731-645-5753 Fax: 731-645-9885
Jonathan Harrison, M.MIN Counselor Medicare: Not Enrolled in Medicare Practice Location: 641 E Poplar Ave, Selmer, TN 38375 Phone: 731-645-5753 Fax: 731-645-9885

Stephanie Goodrum, LPC - Medicare Counselor in Selmer, TN