Ms Nicole Freda Wynder, NCC,LPC, LMFT, LCMHC is a medicare enrolled "Counselor - Professional" provider in Eastville, Virginia. Her current practice location is
17068 Lankford Highway, Eastville, Virginia. You can reach out to her office (for appointments etc.) via phone at
(757) 331-1086.
Ms Nicole Freda Wynder is licensed to practice in Virginia (license number 0701004707) 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 1245567866.
Healthcare Provider's Profile
| Full Name | Ms Nicole Freda Wynder |
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| Gender | Female |
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| Speciality | Counselor - Professional |
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| Location | 17068 Lankford Highway, Eastville, Virginia |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1245567866
- Provider Enumeration Date: 11/04/2009
- Last Update Date: 04/09/2024
Medicare PECOS Information:
- PECOS PAC ID: 1052757101
- Enrollment ID: I20240311003785
Medical Identifiers
Medical identifiers for Ms Nicole Freda Wynder such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1245567866 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 106H00000X | Marriage & Family Therapist | 0717001932 (Virginia) | Secondary |
| 101YP2500X | Counselor - Professional | 0701004707 (Virginia) | Primary |
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 0718000493 (Virginia) | Secondary |
| 101YM0800X | Counselor - Mental Health | 8632 (North Carolina) | Secondary |
| 101YP2500X | Counselor - Professional | LC13822 (Maryland) | Secondary |
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. Ms Nicole Freda Wynder allows following entities to bill medicare on her behalf.
| Entity Name | First Colonial Psychotherapy Services |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1336294479
PECOS PAC ID: 2264334069
Enrollment ID: O20040122000788 |
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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. Ms Nicole Freda Wynder 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 |
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Ms Nicole Freda Wynder, NCC,LPC, LMFT, LCMHC
20280 Market St,
Onancock, VA 23417-1331
Ph: () - | Ms Nicole Freda Wynder, NCC,LPC, LMFT, LCMHC
17068 Lankford Highway,
Eastville, VA 23347
Ph: (757) 331-1086 |
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