Dr Maureen Tara Nickerson, PSYD in Medical Lake, WA

Dr Maureen Tara Nickerson, PSYD is a medicare enrolled "Psychologist - Clinical" provider in Medical Lake, Washington. Her current practice location is 850 W. Maple St., Medical Lake, Washington. You can reach out to her office (for appointments etc.) via phone at (509) 565-4000.

Dr Maureen Tara Nickerson is licensed to practice in Washington (license number PY60778414) 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 1578130274.

Contact Information

	Dr Maureen Tara Nickerson, PSYD
	850 W. Maple St., Medical Lake, WA 99022
	(509) 565-4000
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Dr Maureen Tara Nickerson
Gender	Female
Speciality	Psychologist - Clinical
Location	850 W. Maple St., Medical Lake, Washington
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1578130274
Provider Enumeration Date: 06/10/2021
Last Update Date: 06/10/2021

Medicare PECOS Information:

PECOS PAC ID: 5395127989
Enrollment ID: I20220728002752

Medical Identifiers

Medical identifiers for Dr Maureen Tara Nickerson such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1578130274	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
103TC0700X	Psychologist - Clinical	PY60778414 (Washington)	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. Dr Maureen Tara Nickerson allows following entities to bill medicare on her behalf.

Entity Name	Department Of Social Dept Of Shs Div Of Instns
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1467440602 PECOS PAC ID: 9133013725 Enrollment ID: O20040213000028

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 Maureen Tara Nickerson 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
Dr Maureen Tara Nickerson, PSYD P.o. Box 800, 850 W. Maple St., Medical Lake, WA 99022 Ph: () -	Dr Maureen Tara Nickerson, PSYD 850 W. Maple St., Medical Lake, WA 99022 Ph: (509) 565-4000

Reviews and Comments

Psychologist in Medical Lake, WA

Dr. Darlene E. Walsh-martin, PHD Psychologist Medicare: Not Enrolled in Medicare Practice Location: 850 Maple Street, Eastern State Hospital, Medical Lake, WA 99022 Phone: 509-565-4000 Fax: 509-565-4705
Christina L. Zampich, PSYD Psychologist Medicare: Not Enrolled in Medicare Practice Location: 850 Maple Street, Medical Lake, WA 99022 Phone: 509-565-4000 Fax: 509-565-7015
Dr. Patricia L. Gunderson, PHD Psychologist Medicare: Medicare Enrolled Practice Location: 850 Maple Street, Medical Lake, WA 99022 Phone: 509-565-4000 Fax: 509-565-7015
Lisa Mathews, Psychologist Medicare: Medicare Enrolled Practice Location: 850 W. Maple St., Medical Lake, WA 99022 Phone: 509-565-4000 Fax: 509-565-4705
Dr. Gretchen L. Meader, PHD Psychologist Medicare: Medicare Enrolled Practice Location: 850 Maple St., Medical Lake, WA 99022 Phone: 509-565-4000 Fax: 509-565-4705
Dr. Alton J Couturier, PHD Psychologist Medicare: Not Enrolled in Medicare Practice Location: 800 West Maple Street, Medical Lake, WA 99022 Phone: 509-299-3121 Fax: 509-299-7015
David W. Elkins Jr., PHD Psychologist Medicare: Medicare Enrolled Practice Location: 850 Maple Street, Eastern State Hospital, Medical Lake, WA 99022 Phone: 509-565-4000 Fax: 509-565-4705

Dr Maureen Tara Nickerson, PSYD - Medicare Psychologist in Medical Lake, WA