Melissa Clark, 6002172 | |
6141 Basswood Dr, Columbus, IN 47201-8431 | |
(812) 603-6827 | |
Not Available |
Full Name | Melissa Clark |
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Gender | Female |
Speciality | Social Worker - Clinical |
Location | 6141 Basswood Dr, Columbus, Indiana |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1801967195 | NPI | - | NPPES |
6002172 | Medicaid | NC |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | C003571 (North Carolina) | Secondary |
1041C0700X | Social Worker - Clinical | 34005724A (Indiana) | Primary |
Entity Name | Saint Peter's Lutheran Church |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1477800373 PECOS PAC ID: 8224579818 Enrollment ID: O20240930001788 |
Mailing Address | Practice Location Address |
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Melissa Clark, 6002172 719 5th St, Columbus, IN 47201-6306 Ph: (812) 372-1571 | Melissa Clark, 6002172 6141 Basswood Dr, Columbus, IN 47201-8431 Ph: (812) 603-6827 |
Marilyn Kerns, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 2205 Central Ave, Columbus, IN 47201 Phone: 812-375-1041 | |
Robin Knorr, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 2520 California St Ste A, Columbus, IN 47201 Phone: 812-350-5664 | |
Mary Louise Pruett, LCSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 720 N Marr Rd, Columbus, IN 47201 Phone: 812-314-3400 | |
Charlotte Barton Coombs, LCSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 1531 13th St Ste 2540, Columbus, IN 47201 Phone: 812-372-3745 Fax: 812-954-0888 | |
Reyna Navarro, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1950 Doctors Park Dr, Columbus, IN 47203 Phone: 812-269-2971 | |
Anne-marie Kirkland, LCSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 1531 13th St Ste 2540, Columbus, IN 47201 Phone: 812-372-3745 Fax: 812-954-0888 | |
Andrea Vogel, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 2400 17th St, Columbus, IN 47201 Phone: 812-376-5610 Fax: 812-376-5610 |