Amanda Rae Clark, LCSW in De Pere, WI - Medicare Social Worker Provider

Amanda Rae Clark, LCSW is a medicare enrolled "Social Worker - Clinical" provider in De Pere, Wisconsin. Her current practice location is 1325 Angels Path, De Pere, Wisconsin. You can reach out to her office (for appointments etc.) via phone at (920) 338-2855.

Amanda Rae Clark is licensed to practice in Wisconsin (license number 11492-123) 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 1518732726.

Contact Information

	Amanda Rae Clark, LCSW
	1325 Angels Path, De Pere, WI 54115-4050
	(920) 338-2855
	(920) 338-9270

Map and Direction

Healthcare Provider's Profile

Full Name	Amanda Rae Clark
Gender	Female
Speciality	Social Worker - Clinical
Location	1325 Angels Path, De Pere, Wisconsin
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1518732726
Provider Enumeration Date: 11/17/2023
Last Update Date: 11/21/2023

Medicare PECOS Information:

PECOS PAC ID: 2567811714
Enrollment ID: I20231213001028

Medical Identifiers

Medical identifiers for Amanda Rae Clark such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1518732726	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
1041C0700X	Social Worker - Clinical	11492-123 (Wisconsin)	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. Amanda Rae Clark allows following entities to bill medicare on her behalf.

Entity Name	Bellin Psychiatric Center Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1952554800 PECOS PAC ID: 4486551058 Enrollment ID: O20031212000884

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. Amanda Rae Clark 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
Amanda Rae Clark, LCSW Po Box 22040, Green Bay, WI 54305-2040 Ph: (920) 445-7210	Amanda Rae Clark, LCSW 1325 Angels Path, De Pere, WI 54115-4050 Ph: (920) 338-2855

Reviews and Comments

Social Worker in De Pere, WI

Danielle M Evenson, LCSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 1325 Angels Path, De Pere, WI 54115 Phone: 920-338-2855 Fax: 920-338-9270
Mr. Charles J Latorre, LCSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 1325 Angels Path, De Pere, WI 54115 Phone: 920-338-2855 Fax: 920-338-9270
Ms. Sue Anne Huber, MSW LCSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 1800 Lawrence Dr, De Pere, WI 54115 Phone: 920-336-1229 Fax: 920-983-3226
Nicole Dufek, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 301 N Broadway Ste 303, De Pere, WI 54115 Phone: 877-300-9101
Mrs. Gretchen Anne Ebelt, MSW,LCSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 1325 Angels Path, De Pere, WI 54115 Phone: 920-338-2855 Fax: 920-403-7360
Micayla M Selissen, LCSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 1325 Angels Path, De Pere, WI 54115 Phone: 920-338-2855 Fax: 920-338-9270
Emily Schneider, APSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 555 Redbird Cir, De Pere, WI 54115 Phone: 920-338-6870

Amanda Rae Clark, LCSW - Medicare Clinical Social Worker in De Pere, WI