Dominique M Clark, LCSW - Clinical Social Worker in Walls, MS

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Dominique M Clark, LCSW is a Social Worker - Clinical based in Walls, Mississippi. Dominique M Clark is licensed to practice in Mississippi (license number C10935) and her current practice location is 6551 Anna May Dr, Walls, Mississippi. She can be reached at her office (for appointments etc.) via phone at (901) 359-1283.

NPI number for Dominique M Clark is 1871345892 and her current mailing address is 6551 Anna May Dr, Walls, Mississippi. She does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1871345892.

Contact Information

Dominique M Clark, LCSW
6551 Anna May Dr,
Walls, MS 38680-9214
(901) 359-1283
Not Available

Map and Direction




Healthcare Provider's Profile

Full NameDominique M Clark
GenderFemale
SpecialitySocial Worker - Clinical
Location6551 Anna May Dr, Walls, Mississippi
Accepts Medicare AssignmentsDoes not participate in Medicare Program. She may not accept medicare assignment.
  NPI Data:
  • NPI Number: 1871345892
  • Provider Enumeration Date: 04/03/2024
  • Last Update Date: 04/03/2024

Medical Identifiers

Medical identifiers for Dominique M Clark such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1871345892NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
1041C0700XSocial Worker - Clinical C10935 (Mississippi)Primary

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. Dominique M Clark is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Dominique M Clark, LCSW
6551 Anna May Dr,
Walls, MS 38680-9214

Ph: (901) 359-1283		Dominique M Clark, LCSW
6551 Anna May Dr,
Walls, MS 38680-9214

Ph: (901) 359-1283

Reviews and Comments


Social Worker in Walls, MS

Wendy Mckenzie,
Clinical Social Worker
Medicare: Not Enrolled in Medicare
Practice Location: 6915 Slash Pine Dr, Walls, MS 38680
Phone: 662-655-8553    
Jessica Davis, LCSW
Clinical Social Worker
Medicare: Not Enrolled in Medicare
Practice Location: 6502 Mccoy Cv, Walls, MS 38680
Phone: 662-444-4949    

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.