Tiffaney Nicole Williams-fuller, LCMHC is a medicare enrolled "Psychologist - Counseling" provider in Charlotte, North Carolina. Her current practice location is
501 Billingsley Rd, Ste B, Charlotte, North Carolina. You can reach out to her office (for appointments etc.) via phone at
(704) 444-2400.
Tiffaney Nicole Williams-fuller is licensed to practice in North Carolina (license number 14029) 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 1962166991.
Healthcare Provider's Profile
| Full Name | Tiffaney Nicole Williams-fuller |
|---|
| Gender | Female |
|---|
| Speciality | Psychologist - Counseling |
|---|
| Location | 501 Billingsley Rd, Charlotte, North Carolina |
|---|
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
|---|
NPI Data:
- NPI Number: 1962166991
- Provider Enumeration Date: 10/26/2021
- Last Update Date: 07/15/2024
Medicare PECOS Information:
- PECOS PAC ID: 7416392782
- Enrollment ID: I20240226003408
Medical Identifiers
Medical identifiers for Tiffaney Nicole Williams-fuller such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1962166991 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YP2500X | Counselor - Professional | 14029 (North Carolina) | Secondary |
| 103TC1900X | Psychologist - Counseling | 14029 (North 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. Tiffaney Nicole Williams-fuller allows following entities to bill medicare on her behalf.
| Entity Name | Carolinas Medical Center |
|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
|---|
| Entity Identifiers | NPI Number: 1275774333
PECOS PAC ID: 4789597477
Enrollment ID: O20031110000116 |
|---|
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. Tiffaney Nicole Williams-fuller 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 |
|---|
Tiffaney Nicole Williams-fuller, LCMHC
Po Box 19305,
Charlotte, NC 28219-9305
Ph: () - | Tiffaney Nicole Williams-fuller, LCMHC
501 Billingsley Rd, Ste B,
Charlotte, NC 28211-1009
Ph: (704) 444-2400 |
Reviews and Comments