Mrs Shelly Marie Davenport, MS, LMFT in Champlin, MN - Medicare Marriage & Family Therapist Provider

Mrs Shelly Marie Davenport, MS, LMFT is a medicare enrolled "Marriage & Family Therapist" provider in Champlin, Minnesota. Her current practice location is 11141 Zealand Ave N, Champlin, Minnesota. You can reach out to her office (for appointments etc.) via phone at (763) 951-3091.

Mrs Shelly Marie Davenport is licensed to practice in Minnesota (license number 1139) 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 1134166275.

Contact Information

	Mrs Shelly Marie Davenport, MS, LMFT
	11141 Zealand Ave N, Champlin, MN 55316
	(763) 951-3091
	(763) 951-3097

Map and Direction

Healthcare Provider's Profile

Full Name	Mrs Shelly Marie Davenport
Gender	Female
Speciality	Marriage & Family Therapist
Location	11141 Zealand Ave N, Champlin, Minnesota
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1134166275
Provider Enumeration Date: 05/31/2006
Last Update Date: 05/18/2018

Medicare PECOS Information:

PECOS PAC ID: 2961655162
Enrollment ID: I20231218002583

Medical Identifiers

Medical identifiers for Mrs Shelly Marie Davenport such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1134166275	NPI	-	NPPES
407168900	Medicaid	MN

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
106H00000X	Marriage & Family Therapist	1139 (Minnesota)	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. Mrs Shelly Marie Davenport allows following entities to bill medicare on her behalf.

Entity Name	Beacon Therapy Associates Pc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1407084031 PECOS PAC ID: 4284887472 Enrollment ID: O20130122000412

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. Mrs Shelly Marie Davenport 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
Mrs Shelly Marie Davenport, MS, LMFT 11141 Zealand Ave N, Champlin, MN 55316-3595 Ph: (763) 951-3091	Mrs Shelly Marie Davenport, MS, LMFT 11141 Zealand Ave N, Champlin, MN 55316 Ph: (763) 951-3091

Reviews and Comments

Marriage & Family Therapist in Champlin, MN

Dr. Paul John Dousi, PHD, LMFT Couples Therapy Medicare: Not Enrolled in Medicare Practice Location: 6300 117th Ave N, Champlin, MN 55316 Phone: 763-458-0154 Fax: 763-427-5688
Mrs. Christy L Kane, LAMFT Couples Therapy Medicare: Not Enrolled in Medicare Practice Location: 11188 Zealand Ave N, Champlin, MN 55316 Phone: 763-401-7318 Fax: 763-220-6025
Erica Lynne Gruidl, LMFT Couples Therapy Medicare: Medicare Enrolled Practice Location: 11116 Zealand Ave N, Champlin, MN 55316 Phone: 763-746-0842 Fax: 763-746-0843
Gary R Sandberg, M.A. Couples Therapy Medicare: Not Enrolled in Medicare Practice Location: 11141 Zealand Ave N, Champlin, MN 55316 Phone: 763-291-7065
Anne M Carroll, LMFT Couples Therapy Medicare: Not Enrolled in Medicare Practice Location: 11188 Zealand Ave N, Champlin, MN 55316 Phone: 612-991-8949
Daniel Golat, LAMFT Couples Therapy Medicare: Not Enrolled in Medicare Practice Location: 11141 Zealand Ave N, Champlin, MN 55316 Phone: 763-951-3091

Mrs Shelly Marie Davenport, MS, LMFT - Medicare Couples Therapy in Champlin, MN