Diane Judith Heribacka, LMFT in Titusville, FL

Diane Judith Heribacka, LMFT is a medicare enrolled "Counselor - Mental Health" provider in Titusville, Florida. Her current practice location is 6700 S Washington Ave, Titusville, Florida. You can reach out to her office (for appointments etc.) via phone at (321) 722-5200.

Diane Judith Heribacka is licensed to practice in Florida (license number MT3289) 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 1700169752.

Contact Information

	Diane Judith Heribacka, LMFT
	6700 S Washington Ave, Titusville, FL 32780-8050
	(321) 722-5200
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Diane Judith Heribacka
Gender	Female
Speciality	Counselor - Mental Health
Location	6700 S Washington Ave, Titusville, Florida
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1700169752
Provider Enumeration Date: 09/26/2011
Last Update Date: 05/14/2024

Medicare PECOS Information:

PECOS PAC ID: 3577900919
Enrollment ID: I20240321001660

Medical Identifiers

Medical identifiers for Diane Judith Heribacka such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1700169752	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
106H00000X	Marriage & Family Therapist	35001728A (Indiana)	Secondary
101YM0800X	Counselor - Mental Health	MT3289 (Florida)	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. Diane Judith Heribacka allows following entities to bill medicare on her behalf.

Entity Name	Mcr Health Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1255376000 PECOS PAC ID: 7214847995 Enrollment ID: O20040126000213

Entity Name	Balanced Wellbeing Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1336513639 PECOS PAC ID: 5193021848 Enrollment ID: O20160307002587

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. Diane Judith Heribacka 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
Diane Judith Heribacka, LMFT 400 Sheridan Rd, Melbourne, FL 32901-3122 Ph: (321) 722-5200	Diane Judith Heribacka, LMFT 6700 S Washington Ave, Titusville, FL 32780-8050 Ph: (321) 722-5200

Reviews and Comments

Counselor in Titusville, FL

Dr. Patricia Ann Stelzriede, PSY.D. Counselor Medicare: Not Enrolled in Medicare Practice Location: 1313 S Washington Ave Ste E, Titusville, FL 32780 Phone: 321-267-7773 Fax: 321-267-7535
Mr. Edward Joseph Manzano Jr., M.ED Counselor Medicare: Not Enrolled in Medicare Practice Location: 1850 S Deleon Ave, Titusville, FL 32780 Phone: 321-264-5000
Betty Bobay, Counselor Medicare: Not Enrolled in Medicare Practice Location: 5944 Windover Way, Titusville, FL 32780 Phone: 321-795-0459
Stephanie Stevens, Counselor Medicare: Medicare Enrolled Practice Location: 6650 S Fork, Titusville, FL 32780 Phone: 407-467-4798
Mr. Daniel J. Resh Jr., LMHC Counselor Medicare: Not Enrolled in Medicare Practice Location: 6700 S Washington Ave, Titusville, FL 32780 Phone: 321-269-4590 Fax: 321-268-5689
Ms. Deborah Ann Abram, LMHC Counselor Medicare: Not Enrolled in Medicare Practice Location: 6700 S. Us Hwy 1, Titusville, FL 32780 Phone: 321-480-9079
Mrs. Heather Ashley Rohaus, LMHC, MS Counselor Medicare: Not Enrolled in Medicare Practice Location: 1850 S Deleon Ave, Titusville, FL 32780 Phone: 407-240-5244

Diane Judith Heribacka, LMFT - Medicare Counselor in Titusville, FL