Mrs Destiny Miller Mangan, MS CCC-SLP in Clayton, GA - Medicare Speech-Language Pathologist Provider

Mrs Destiny Miller Mangan, MS CCC-SLP is a medicare enrolled "Speech-language Pathologist" provider in Clayton, Georgia. Her current practice location is 165 Ridgecrest Cir, Clayton, Georgia. You can reach out to her office (for appointments etc.) via phone at (678) 357-5849.

Mrs Destiny Miller Mangan is licensed to practice in Georgia (license number SLP012443) 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 1245982289.

Contact Information

	Mrs Destiny Miller Mangan, MS CCC-SLP
	165 Ridgecrest Cir, Clayton, GA 30525-4110
	(678) 357-5849
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Mrs Destiny Miller Mangan
Gender	Female
Speciality	Speech-language Pathologist
Location	165 Ridgecrest Cir, Clayton, Georgia
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1245982289
Provider Enumeration Date: 01/20/2022
Last Update Date: 01/01/2024

Medicare PECOS Information:

PECOS PAC ID: 6103279476
Enrollment ID: I20240202001265

Medical Identifiers

Medical identifiers for Mrs Destiny Miller Mangan such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1245982289	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
235Z00000X	Speech-language Pathologist	PCET003509 (Georgia)	Secondary
235Z00000X	Speech-language Pathologist	SLP012443 (Georgia)	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 Destiny Miller Mangan allows following entities to bill medicare on her behalf.

Provider Name	Fundamental Therapy Services Llc
Provider Type	Part B Supplier - Clinic/group Practice
Provider Identifiers	NPI Number: 1780110155 PECOS PAC ID: 4789936113 Enrollment ID: O20181011002104

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 Destiny Miller Mangan 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 Destiny Miller Mangan, MS CCC-SLP 165 Ridgecrest Cir, Clayton, GA 30525-4110 Ph: (678) 357-5849	Mrs Destiny Miller Mangan, MS CCC-SLP 165 Ridgecrest Cir, Clayton, GA 30525-4110 Ph: (678) 357-5849

Reviews and Comments

Speech-Language Pathologist in Clayton, GA

Mrs. Bree Hickox Bragg, MED, CCC-SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 8857 Highway 76 W, Clayton, GA 30525 Phone: 706-224-4575
Anne Reed Rickman, M.ED., CCC-SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 165 Ridgecrest Cir, Clayton, GA 30525 Phone: 706-782-6330
Miranda Rae Hunnicutt, Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 165 Ridgecrest Cir, Clayton, GA 30525 Phone: 678-357-5849
Mrs. Suzanne A Frederickson, CCC-SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: Highlands Internal Medicine, Pc, 156 North Main St, Clayton, GA 30525 Phone: 706-212-0390 Fax: 706-960-9209

Mrs Destiny Miller Mangan, MS CCC-SLP - Medicare Speech-Language Pathologist in Clayton, GA