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Lavera G Mccaskill

Social Worker

Behavioral Health & Social Service Providers

1030 Jefferson Ave, Memphis, TN 38104-2127

PECOS Enrollment

This provider is enrolled in PECOS as LAVERA MCCASKILL.

Based on the most recent information from CMS, provider Lavera G Mccaskill is legally eligible to order and refer claims for Part B and DME services only.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1316272834
Provider Type
Individual
Full Name
Mccaskill, Lavera G
Title
Ms.
Credential
LCSW

Gender
Female
Sole Proprietor
No
Enumeration Date
10/16/2009
Last Updated
12/22/2022

Contact Information

Practice Location

1030 Jefferson Ave, Memphis, TN 38104-2127

(901) 523-8990

Unlisted Fax

Mailing Location

9049 William Paul Dr, Olive Branch, MS 38654-6430

(662) 812-1288

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 1041C0700X Primary	Description Social Worker Behavioral Health & Social Service Providers	License C9863 Mississippi
Code 101YM0800X	Description Counselor Behavioral Health & Social Service Providers	License Unlisted Issuer
Code 1041C0700X	Description Social Worker Behavioral Health & Social Service Providers	License Unlisted Issuer
Code 1041C0700X	Description Social Worker Behavioral Health & Social Service Providers	License 6847 Tennessee

Lavera G Mccaskill

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Code

Description

License

Code

Description

License

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