Chanella Latre Clark, LPCC in Nashville, TN - Medicare Counselor Provider

Chanella Latre Clark, LPCC is a medicare enrolled "Counselor - Mental Health" provider in Nashville, Tennessee. Her current practice location is 210 25th Ave N Ste 601, Nashville, Tennessee. You can reach out to her office (for appointments etc.) via phone at (615) 337-8709.

Chanella Latre Clark is licensed to practice in Kentucky (license number 281173) 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 1548823826.

Contact Information

	Chanella Latre Clark, LPCC
	210 25th Ave N Ste 601, Nashville, TN 37203-1631
	(615) 337-8709
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Chanella Latre Clark
Gender	Female
Speciality	Counselor - Mental Health
Location	210 25th Ave N Ste 601, Nashville, Tennessee
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1548823826
Provider Enumeration Date: 04/22/2019
Last Update Date: 10/24/2022

Medicare PECOS Information:

PECOS PAC ID: 4183063225
Enrollment ID: I20240422002423

Medical Identifiers

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

Identifier	Type	State	Issuer
1548823826	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
101YM0800X	Counselor - Mental Health	281173 (Kentucky)	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. Chanella Latre Clark allows following entities to bill medicare on her behalf.

Entity Name	Family Care Center Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1124756085 PECOS PAC ID: 5991064420 Enrollment ID: O20230501001893

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. Chanella Latre 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
Chanella Latre Clark, LPCC 1515 5th Ave N Apt 204, Nashville, TN 37208-2798 Ph: (615) 337-8709	Chanella Latre Clark, LPCC 210 25th Ave N Ste 601, Nashville, TN 37203-1631 Ph: (615) 337-8709

Reviews and Comments

Counselor in Nashville, TN

Regina Peterson, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1601 23rd Ave S, 3rd Floor, Nashville, TN 37212 Phone: 615-327-7009 Fax: 615-343-4595
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Alex Donchevel Ellis, Counselor Medicare: Not Enrolled in Medicare Practice Location: 230 Venture Cir, Nashville, TN 37228 Phone: 615-460-4100
Jessica Leann Smith, LPC-MHSP Counselor Medicare: Not Enrolled in Medicare Practice Location: 210 25th Ave N, Nashville, TN 37203 Phone: 615-933-8772

Chanella Latre Clark, LPCC - Medicare Counselor in Nashville, TN