Annette R Clark, LPCC in Toledo, OH - Medicare Counselor Provider

Annette R Clark, LPCC is a medicare enrolled "Counselor - Professional" provider in Toledo, Ohio. Her current practice location is 123 22nd St, Toledo, Ohio. You can reach out to her office (for appointments etc.) via phone at (419) 241-6191.

Annette R Clark is licensed to practice in Ohio (license number E 0003343) 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 1902022999.

Contact Information

	Annette R Clark, LPCC
	123 22nd St, Toledo, OH 43624-1107
	(419) 241-6191
	(419) 255-5623

Map and Direction

Healthcare Provider's Profile

Full Name	Annette R Clark
Gender	Female
Speciality	Counselor - Professional
Location	123 22nd St, Toledo, Ohio
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1902022999
Provider Enumeration Date: 04/18/2007
Last Update Date: 07/08/2007

Medicare PECOS Information:

PECOS PAC ID: 6507201266
Enrollment ID: I20240304003146

Medical Identifiers

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

Identifier	Type	State	Issuer
1902022999	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
101YP2500X	Counselor - Professional	E 0003343 (Ohio)	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. Annette R Clark allows following entities to bill medicare on her behalf.

Entity Name	Fort Meigs Psychological Service
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1649337817 PECOS PAC ID: 5799831624 Enrollment ID: O20090918000117

Entity Name	Fort Meigs Wellness & Behavioral Health Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1679323547 PECOS PAC ID: 3375983919 Enrollment ID: O20240430003713

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. Annette R 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
Annette R Clark, LPCC 123 22nd St, Toledo, OH 43624-1107 Ph: (419) 241-6191	Annette R Clark, LPCC 123 22nd St, Toledo, OH 43624-1107 Ph: (419) 241-6191

Reviews and Comments

Counselor in Toledo, OH

Jonna Marie Brendle, LPCC-S Counselor Medicare: Not Enrolled in Medicare Practice Location: 123 22nd St, Toledo, OH 43604 Phone: 419-241-6191
Kelly A Garza, LSW, LCDCIII-GAMB Counselor Medicare: Not Enrolled in Medicare Practice Location: 2005 Ashland Ave, Toledo, OH 43620 Phone: 419-841-7701
Lanaya Mcdonald, PC Counselor Medicare: Not Enrolled in Medicare Practice Location: 3350 Collingwood Blvd, Toledo, OH 43610 Phone: 419-255-9585 Fax: 419-255-0207
Ms. Lauren Michelle Merrell, MSW, LSW Counselor Medicare: Not Enrolled in Medicare Practice Location: 5151 Monroe St Ste 200, Toledo, OH 43623 Phone: 419-475-4449
Shana Bentley, M.A., LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 424 W Woodruff Ave, Toledo, OH 43604 Phone: 419-841-7701
Leslie Anne Fern, Counselor Medicare: Medicare Enrolled Practice Location: 4334 Secor Rd, Toledo, OH 43623 Phone: 419-351-1337
Dinisha Paul, Counselor Medicare: Not Enrolled in Medicare Practice Location: 5577 Airport Hwy Ste 102, Toledo, OH 43615 Phone: 419-214-1770 Fax: 419-214-0922

Annette R Clark, LPCC - Medicare Counselor in Toledo, OH