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Lucille C Correa

Social Worker

Behavioral Health & Social Service Providers

1155 N State St Ste 608, Bellingham, WA 98225-5024

PECOS Enrollment

This provider is enrolled in PECOS as LUCILLE CORREA.

Based on the most recent information from CMS, provider Lucille C Correa 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
1548676547
Provider Type
Individual
Full Name
Correa, Lucille C
Credential
LICSW

Gender
Female
Sole Proprietor
No
Enumeration Date
7/10/2014
Last Updated
2/8/2019

Contact Information

Practice Location

1155 N State St Ste 608, Bellingham, WA 98225-5024

(360) 224-2631

Unlisted Fax

Mailing Location

7762 Cascades Dr, Maple Falls, WA 98266-7713

(360) 224-2631

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 1041C0700X Primary	Description Social Worker Behavioral Health & Social Service Providers	License LW 60706363 Washington
Code 101YM0800X	Description Counselor Behavioral Health & Social Service Providers	License LH60594466 Washington

Provider Identifiers

ID	Description	Issuer
ID 2038669	Description Medicaid	Issuer Unlisted Washington

Lucille C Correa

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

Davidge, Ann Marie

Leedom, Erin

Thorndike, Kathleen Lambert

Evans, Claire

Crouse, Megan A.

Suni, Heidi

Creed, Melinda

Dashiell, Dennis

Shawver, Debra Jean

Roskelley, Jeffery James