Krystal Clark, in Ellijay, GA - Medicare Social Worker Provider

Krystal Clark, is a medicare enrolled "Social Worker - Clinical" provider in Ellijay, Georgia. Her current practice location is 917 Parker Rd, Ellijay, Georgia. You can reach out to her office (for appointments etc.) via phone at (678) 357-7224.

Krystal Clark is licensed to practice in Georgia (license number CSW008048) 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 1346988441.

Contact Information

	Krystal Clark,
	917 Parker Rd, Ellijay, GA 30536-7957
	(678) 357-7224
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Krystal Clark
Gender	Female
Speciality	Social Worker - Clinical
Location	917 Parker Rd, Ellijay, Georgia
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1346988441
Provider Enumeration Date: 05/26/2022
Last Update Date: 05/26/2022

Medicare PECOS Information:

PECOS PAC ID: 7719353473
Enrollment ID: I20221020001537

Medical Identifiers

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

Identifier	Type	State	Issuer
1346988441	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
1041C0700X	Social Worker - Clinical	CSW008048 (Georgia)	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. Krystal Clark allows following entities to bill medicare on her behalf.

Entity Name	Lifesource Of North Carolina
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1962940817 PECOS PAC ID: 7416132428 Enrollment ID: O20170418000863

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. Krystal 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
Krystal Clark, 917 Parker Rd, Ellijay, GA 30536-7957 Ph: (678) 357-7224	Krystal Clark, 917 Parker Rd, Ellijay, GA 30536-7957 Ph: (678) 357-7224

Reviews and Comments

Social Worker in Ellijay, GA

Michel Bordeau, MA, LCSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 968 Summit Ln # 1042, Ellijay, GA 30540 Phone: 404-798-9799
Juni Verser, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 293 Progress Rd, Ellijay, GA 30540 Phone: 706-273-2225
Vickie Harrison, LMSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 18090 Highway 515 N, P. O. 422, Ellijay, GA 30536 Phone: 706-276-2024 Fax: 706-276-1502
Mrs. Ardin Parker Lingle Chastain, LCSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 142 River Ter, Ellijay, GA 30540 Phone: 770-377-2084
Hilda Grindell, LCSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 9 Russell Dr Ste 201, Ellijay, GA 30540 Phone: 762-233-4869
Ms. Cheryl M. Keats, LCSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 89 Hospital Cir, Suite 8, Ellijay, GA 30540 Phone: 706-698-2400 Fax: 706-698-2401

Krystal Clark, - Medicare Clinical Social Worker in Ellijay, GA