MARCIA WINTER LPCMH
NPI 1700914728
Counselor in Wilmington, DE
NPI Status: Active since March 01, 2007
Contact Information
1601 CONCORD PIKE
SUITE 92-100
WILMINGTON, DE
ZIP 19803
Phone: (302) 409-3434
Fax: (302) 654-1317
- Individual
- Female
- Years of Experience 27
- Counselor
- Accepts Insurance
- Accepts Medicare Approved Payment
- PECOS Enrolled
About MARCIA WINTER
This page provides the complete NPI Profile along with additional information for Marcia Winter, a provider established in Wilmington, Delaware with a medical specialization in Counselor and more than 27 years of experience. The healthcare provider is registered in the NPI registry with number 1700914728 assigned on March 2007. The practitioner's primary taxonomy code is 101Y00000X with license number PC-0000237 (DE). The provider is registered as an individual and her NPI record was last updated 13 years ago.
- NPI
- 1700914728
- Provider Name
- MARCIA WINTER LPCMH
- Gender
- Female
- Entity Type
- Individual
- Location Address
- 1601 CONCORD PIKE SUITE 92-100 WILMINGTON, DE 19803
- Location Phone
- (302) 409-3434
- Location Fax
- (302) 654-1317
- Mailing Address
- 402 FOULK RD APT. 2C8 WILMINGTON, DE 19803
- Mailing Phone
- (302) 652-5090
- Medical School Name
- OTHER
- Graduation Year
- 1999
- Is Sole Proprietor?
- Yes
- Enumeration Date
- 03-01-2007
- Last Update Date
- 08-08-2013
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Counselor
- Taxonomy Code
- 101Y00000X
- Type
- Behavioral Health & Social Service Providers
- License No.
- PC-0000237
- License State
- DE
- Taxonomy Description
- A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- AmeriHealth Caritas Next Bronze Essential + No Referrals - HMO
- AmeriHealth Caritas Next Bronze Premier + No Referrals - HMO
- AmeriHealth Caritas Next Bronze Signature + No Referrals - HMO
- AmeriHealth Caritas Next Gold Premier + No Referrals - HMO
- AmeriHealth Caritas Next Gold Signature + No Referrals - HMO
- AmeriHealth Caritas Next Silver Essential + No Referrals - HMO
- AmeriHealth Caritas Next Silver Premier + No Referrals - HMO
- AmeriHealth Caritas Next Silver Signature + No Referrals - HMO
- my Blue Access Major Events Select PPO Catastrophic 10600 - 3 Free PCP Visits - PPO
- my Blue Access Select PPO Bronze 3800 - PPO
- my Blue Access Select PPO Bronze 3800 + Adult Dental and Vision - PPO
- my Blue Access Select PPO Bronze 9200 - PPO
- my Blue Access Select PPO Gold 0 - PPO
- my Blue Access Select PPO Gold 0 + Adult Dental and Vision - PPO
- my Blue Access Select PPO Gold 1700 HSA - PPO
- my Blue Access Select PPO Premier Gold 0 + Adult Dental and Vision - PPO
- my Blue Access Select PPO Premier Platinum 0 + Adult Dental and Vision - PPO
- my Blue Access Select PPO Premier Silver 0 + Adult Dental and Vision - PPO
- my Blue Access Select PPO Standard Bronze 7500 - PPO
- my Blue Access Select PPO Standard Gold 2000 - PPO
- my Blue Access Select PPO Standard Gold 2000 + Adult Dental and Vision - PPO
- my Blue Access Select PPO Standard Platinum 0 - PPO
- my Blue Access Select PPO Standard Silver 6000 - PPO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Medicare Participation & PECOS Enrollment Status
Marcia Winter is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.
Marcia Winter is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging and Durable Medical Equipment (DME).
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
PECOS PAC ID: 2365894037
What is the PECOS Associate Control ID?
A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.PECOS Enrollment ID: I20240118000460
What is the Provider Enrollment ID?
The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.Accepts Medicare Assignment? Yes
What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): No
Eligible to Order or Refer Power Mobility Devices: No
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1700914728, we treat the final digit (8) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 62. The final step is to find the difference between that total and the next multiple of ten (70 - 62 = 8).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 62 is 70. The difference is the calculated check digit.
Other Providers at the Same Location
The following 20 providers are registered at the same or a nearby location.
WILMINGTON, DE 19803
WILMINGTON, DE 19803
WILMINGTON, DE 19803
WILMINGTON, DE 19803
WILMINGTON, DE 19803
WILMINGTON, DE 19803
WILMINGTON, DE 19803
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1700914728, enumerated as an "individual" on March 01, 2007.
The provider is located at 1601 CONCORD PIKE SUITE 92-100 WILMINGTON, DE 19803 and the phone number is (302) 409-3434.
Counselor with taxonomy code 101Y00000X.
The provider might be accepting Accepts: AmeriHealth Caritas Next and Highmark Blue Cross. Please consult your insurance carrier or call the provider to verify.
