Caroline Chalk, LPC-IT, SAC-IT in Wautoma, WI

Caroline Chalk, LPC-IT, SAC-IT is a medicare enrolled "Counselor - Professional" provider in Wautoma, Wisconsin. Her current practice location is 400 S Townline Rd, Wautoma, Wisconsin. You can reach out to her office (for appointments etc.) via phone at (920) 787-5514.

Caroline Chalk is licensed to practice in Wisconsin (license number 4651-226) 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 1316531932.

Contact Information

	Caroline Chalk, LPC-IT, SAC-IT
	400 S Townline Rd, Wautoma, WI 54982-6922
	(920) 787-5514
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Caroline Chalk
Gender	Female
Speciality	Counselor - Professional
Location	400 S Townline Rd, Wautoma, Wisconsin
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1316531932
Provider Enumeration Date: 02/24/2021
Last Update Date: 02/24/2021

Medicare PECOS Information:

PECOS PAC ID: 5991149122
Enrollment ID: I20240215003342

Medical Identifiers

Medical identifiers for Caroline Chalk such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1316531932	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
101YA0400X	Counselor - Addiction (substance Use Disorder)	19114-130 (Wisconsin)	Secondary
101YP2500X	Counselor - Professional	4651-226 (Wisconsin)	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. Caroline Chalk allows following entities to bill medicare on her behalf.

Entity Name	Aurora Medical Group, Inc.
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1427271378 PECOS PAC ID: 6709794258 Enrollment ID: O20031105000725

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. Caroline Chalk 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
Caroline Chalk, LPC-IT, SAC-IT 400 S Townline Rd, Wautoma, WI 54982-6922 Ph: (920) 787-5514	Caroline Chalk, LPC-IT, SAC-IT 400 S Townline Rd, Wautoma, WI 54982-6922 Ph: (920) 787-5514

Reviews and Comments

Counselor in Wautoma, WI

Debra Jodarski, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: N4107 13th Ln, Wautoma, WI 54982 Phone: 920-787-2725
Patrick Isenberger, CSAC Counselor Medicare: Not Enrolled in Medicare Practice Location: 230 Park St, Wautoma, WI 54982 Phone: 920-787-6550
Andrea Lee Behnke, APSW, SAC-IT Counselor Medicare: Not Enrolled in Medicare Practice Location: 230 Park St, Wautoma, WI 54982 Phone: 920-787-6550 Fax: 920-787-0421
Michele L Rasmussen, MA, LPC Counselor Medicare: Medicare Enrolled Practice Location: 400 S Townline Rd, Wautoma, WI 54982 Phone: 920-787-5514 Fax: 920-787-4737
Bethany Walker, APSW Counselor Medicare: Not Enrolled in Medicare Practice Location: 380 S Townline Rd, Wautoma, WI 54982 Phone: 920-787-6550 Fax: 920-787-0421
Mr. Paul Francis Theyel, CICSW Counselor Medicare: Not Enrolled in Medicare Practice Location: 230 Park St, Wautoma, WI 54982 Phone: 920-787-6550 Fax: 920-787-0421
Jena Vonfeldt, LCSW Counselor Medicare: Not Enrolled in Medicare Practice Location: N3095 Lake Dr, Wautoma, WI 54982 Phone: 406-212-3293

Caroline Chalk, LPC-IT, SAC-IT - Medicare Counselor in Wautoma, WI