Wallace Goodman, in Hayti, MO - Medicare Counselor Provider

Wallace Goodman, is a medicare enrolled "Counselor - Addiction (substance Use Disorder)" provider in Hayti, Missouri. His current practice location is 501 Highway J N, Hayti, Missouri. You can reach out to his office (for appointments etc.) via phone at (573) 359-2600.

Wallace Goodman is licensed to practice in Missouri (license number 2011024580) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1427488055.

Contact Information

	Wallace Goodman,
	501 Highway J N, Hayti, MO 63851
	(573) 359-2600
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Wallace Goodman
Gender	Male
Speciality	Counselor - Addiction (substance Use Disorder)
Location	501 Highway J N, Hayti, Missouri
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1427488055
Provider Enumeration Date: 11/18/2013
Last Update Date: 11/18/2013

Medicare PECOS Information:

PECOS PAC ID: 1456700913
Enrollment ID: I20231208001502

Medical Identifiers

Medical identifiers for Wallace Goodman such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1427488055	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
101YA0400X	Counselor - Addiction (substance Use Disorder)	2011024580 (Missouri)	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. Wallace Goodman allows following entities to bill medicare on his behalf.

Entity Name	Family Counseling Center Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1669477550 PECOS PAC ID: 2163410481 Enrollment ID: O20040609001127

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. Wallace Goodman 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
Wallace Goodman, 2009 Southwind Cv, Dyersburg, TN 38024-8875 Ph: () -	Wallace Goodman, 501 Highway J N, Hayti, MO 63851 Ph: (573) 359-2600

Reviews and Comments

Counselor in Hayti, MO

Ronnie Sells, Counselor Medicare: Not Enrolled in Medicare Practice Location: 500 Highway J, Hayti, MO 63851 Phone: 573-359-2600
Rebecca Sue Shelton, LPC Counselor Medicare: Medicare Enrolled Practice Location: 500 Highway J, Hayti, MO 63851 Phone: 573-359-2600
Doyletta Thrasher, Counselor Medicare: Not Enrolled in Medicare Practice Location: 500 Highway J, Hayti, MO 63851 Phone: 573-359-2600
Larry Hampton, CSAC Counselor Medicare: Not Enrolled in Medicare Practice Location: 500 Hwy J North, Hayti, MO 63851 Phone: 573-359-2600 Fax: 573-359-1103
Jessica Marie Walker, RASAC 1 Counselor Medicare: Not Enrolled in Medicare Practice Location: 500 Hwy J, Hayti, MO 63851 Phone: 573-359-2600 Fax: 573-359-1103
Mr. Derek Luther Jackson, B.S. Counselor Medicare: Not Enrolled in Medicare Practice Location: 581 Highway J North, Hayti, MO 63851 Phone: 573-359-2600
Mrs. Maryann Hartsfield, CSAC II Counselor Medicare: Not Enrolled in Medicare Practice Location: 500 Us Highway 61 N, Highway J, Hayti, MO 63851 Phone: 573-359-2600 Fax: 573-359-1103

Wallace Goodman, - Medicare Counselor in Hayti, MO