Tara D Ancrum, LPC is a medicare enrolled "Counselor - Professional" provider in Hollywood, South Carolina. Her current practice location is
5740 Ancrum Butler Ln, Hollywood, South Carolina. You can reach out to her office (for appointments etc.) via phone at
(843) 437-0372.
Tara D Ancrum is licensed to practice in South Carolina (license number 6589) 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 1275086480.
Healthcare Provider's Profile
Full Name | Tara D Ancrum |
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Gender | Female |
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Speciality | Counselor - Professional |
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Location | 5740 Ancrum Butler Ln, Hollywood, South Carolina |
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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: 1275086480
- Provider Enumeration Date: 07/25/2016
- Last Update Date: 04/21/2022
Medicare PECOS Information:
- PECOS PAC ID: 6305282419
- Enrollment ID: I20240312001654
Medical Identifiers
Medical identifiers for Tara D Ancrum such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1275086480 | NPI | - | NPPES |
435201 | Medicaid | SC | |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
101YM0800X | Counselor - Mental Health | 6589 (South Carolina) | Secondary |
101YM0800X | Counselor - Mental Health | 6126 (South Carolina) | Secondary |
101YP2500X | Counselor - Professional | 6589 (South Carolina) | 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. Tara D Ancrum allows following entities to bill medicare on her behalf.
Entity Name | University Medical Associates |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1043241110 PECOS PAC ID: 6305758574 Enrollment ID: O20031105000291 |
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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. Tara D Ancrum 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 |
Tara D Ancrum, LPC 5740 Ancrum Butler Ln, Hollywood, SC 29449-7101 Ph: (843) 437-0372 | Tara D Ancrum, LPC 5740 Ancrum Butler Ln, Hollywood, SC 29449-7101 Ph: (843) 437-0372 |
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