Sation Konchellah, is a medicare enrolled "Counselor - Professional" provider in Burlington, North Carolina. Her current practice location is
2224 Lacy St, Burlington, North Carolina. You can reach out to her office (for appointments etc.) via phone at
(336) 494-5743.
Sation Konchellah is licensed to practice in North Carolina (license number A11840) 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 1144613043.
Healthcare Provider's Profile
| Full Name | Sation Konchellah |
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| Gender | Female |
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| Speciality | Counselor - Professional |
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| Location | 2224 Lacy St, Burlington, North Carolina |
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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: 1144613043
- Provider Enumeration Date: 03/17/2015
- Last Update Date: 07/06/2021
Medicare PECOS Information:
- PECOS PAC ID: 6103278890
- Enrollment ID: I20240118001103
Medical Identifiers
Medical identifiers for Sation Konchellah such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1144613043 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 103TS0200X | Psychologist - School | 1068603 (North Carolina) | Secondary |
| 101YP2500X | Counselor - Professional | A11840 (North Carolina) | 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. Sation Konchellah allows following entities to bill medicare on her behalf.
| Entity Name | Grace Counseling And Wellness |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1376068528
PECOS PAC ID: 3476905167
Enrollment ID: O20240118001046 |
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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. Sation Konchellah 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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Sation Konchellah,
Po Box 122,
Sedalia, NC 27342
Ph: (336) 494-5743 | Sation Konchellah,
2224 Lacy St,
Burlington, NC 27215
Ph: (336) 494-5743 |
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