Dr Constance Lee Woythal, PSYD is a medicare enrolled "Psychologist - Clinical" provider in Plymouth, Wisconsin. Her current practice location is
859 Chaplin Ct, Plymouth, Wisconsin. You can reach out to her office (for appointments etc.) via phone at
(920) 893-8000.
Dr Constance Lee Woythal is licensed to practice in Wisconsin (license number 2322) 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 1275656084.
Healthcare Provider's Profile
| Full Name | Dr Constance Lee Woythal |
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| Gender | Female |
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| Speciality | Psychologist - Clinical |
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| Location | 859 Chaplin Ct, Plymouth, Wisconsin |
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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: 1275656084
- Provider Enumeration Date: 04/08/2007
- Last Update Date: 01/15/2015
Medicare PECOS Information:
- PECOS PAC ID: 3577468487
- Enrollment ID: I20031204000228
Medical Identifiers
Medical identifiers for Dr Constance Lee Woythal such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1275656084 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 103TC0700X | Psychologist - Clinical | 2322 (Wisconsin) | Primary |
| 103TC2200X | Psychologist - Clinical Child & Adolescent | 2322 (Wisconsin) | Secondary |
| 103TM1800X | Psychologist - Intellectual & Developmental Disabilities | 2322 (Wisconsin) | 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. Dr Constance Lee Woythal allows following entities to bill medicare on her behalf.
| Entity Name | Wellqor Psychological Services Pc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1063920841
PECOS PAC ID: 1658633292
Enrollment ID: O20230815003625 |
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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. Dr Constance Lee Woythal 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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Dr Constance Lee Woythal, PSYD
859 Chaplin Ct,
Plymouth, WI 53073-1012
Ph: (920) 893-8000 | Dr Constance Lee Woythal, PSYD
859 Chaplin Ct,
Plymouth, WI 53073-1012
Ph: (920) 893-8000 |
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