Holly M Clevenger, MSW is a medicare enrolled "Social Worker - Clinical" provider in Sullivan, Indiana. Her current practice location is
2200 N Section St, Sullivan, Indiana. You can reach out to her office (for appointments etc.) via phone at
(812) 268-4311.
Holly M Clevenger is licensed to practice in * (Not Available) (license number ) 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 1760018691.
Healthcare Provider's Profile
Full Name | Holly M Clevenger |
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Gender | Female |
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Speciality | Social Worker - Clinical |
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Location | 2200 N Section St, Sullivan, Indiana |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1760018691
- Provider Enumeration Date: 03/23/2020
- Last Update Date: 03/23/2020
Medicare PECOS Information:
- PECOS PAC ID: 6002245354
- Enrollment ID: I20200407003096
Medical Identifiers
Medical identifiers for Holly M Clevenger such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1760018691 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
1041C0700X | Social Worker - Clinical | (* (Not Available)) | 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. Holly M Clevenger allows following entities to bill medicare on her behalf.
Entity Name | Sullivan County Community Hospital |
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Entity Type | Part A Provider - Critical Access Hospital |
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Entity Identifiers | NPI Number: 1497759260 PECOS PAC ID: 2466497482 Enrollment ID: O20061104000528 |
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Entity Name | Sullivan County Community Hospital |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1497759260 PECOS PAC ID: 2466497482 Enrollment ID: O20070817000379 |
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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. Holly M Clevenger 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 |
Holly M Clevenger, MSW Po Box 10, Sullivan, IN 47882-0010 Ph: (812) 268-4311 | Holly M Clevenger, MSW 2200 N Section St, Sullivan, IN 47882-7523 Ph: (812) 268-4311 |
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