Dr Clarence Carl Wilson, DBH, LPCC in Colton, CA

Dr Clarence Carl Wilson, DBH, LPCC is a medicare enrolled "Counselor - Mental Health" provider in Colton, California. His current practice location is 851 S Mount Vernon Ave Ste 7a, Colton, California. You can reach out to his office (for appointments etc.) via phone at (760) 241-6044.

Dr Clarence Carl Wilson is licensed to practice in California (license number 2784) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1033496245.

Contact Information

	Dr Clarence Carl Wilson, DBH, LPCC
	851 S Mount Vernon Ave Ste 7a, Colton, CA 92324-3926
	(760) 241-6044
	(760) 820-2704

Map and Direction

Healthcare Provider's Profile

Full Name	Dr Clarence Carl Wilson
Gender	Male
Speciality	Counselor - Mental Health
Location	851 S Mount Vernon Ave Ste 7a, Colton, California
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1033496245
Provider Enumeration Date: 11/16/2011
Last Update Date: 01/11/2024

Medicare PECOS Information:

PECOS PAC ID: 3577915222
Enrollment ID: I20240206000670

Medical Identifiers

Medical identifiers for Dr Clarence Carl Wilson such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1033496245	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
101YA0400X	Counselor - Addiction (substance Use Disorder)	RA8320316 (California)	Secondary
101YM0800X	Counselor - Mental Health	074006 (Iowa)	Secondary
101YM0800X	Counselor - Mental Health	2011031159 (Missouri)	Secondary
101YP2500X	Counselor - Professional	2784 (California)	Secondary
101YM0800X	Counselor - Mental Health	2784 (California)	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. Dr Clarence Carl Wilson allows following entities to bill medicare on his behalf.

Entity Name	Covenant Counseling
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1164967527 PECOS PAC ID: 2668824319 Enrollment ID: O20240117004850

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. Dr Clarence Carl Wilson 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
Dr Clarence Carl Wilson, DBH, LPCC 851 S Mount Vernon Ave Ste 7a, Colton, CA 92324-3926 Ph: (760) 241-6044	Dr Clarence Carl Wilson, DBH, LPCC 851 S Mount Vernon Ave Ste 7a, Colton, CA 92324-3926 Ph: (760) 241-6044

Reviews and Comments

Counselor in Colton, CA

Ms. Judith A Tate, LSW Counselor Medicare: Not Enrolled in Medicare Practice Location: 1330 E Cooley Dr, Colton, CA 92324 Phone: 909-580-3705 Fax: 909-803-3747
Maria Lugo, BA Counselor Medicare: Not Enrolled in Medicare Practice Location: 1430 E Cooley Dr Ste 240, Colton, CA 92324 Phone: 909-433-0445
Miss Jessica Estrada, RECOVERY WORKER Counselor Medicare: Not Enrolled in Medicare Practice Location: 2275 E Cooley Dr, Colton, CA 92324 Phone: 909-370-1777 Fax: 909-370-1776
Katie Wiseman, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1461 E Cooley Dr Ste 100, Colton, CA 92324 Phone: 877-527-7227
Nicole Shaver, Counselor Medicare: Not Enrolled in Medicare Practice Location: 23950 Prado Ln, Colton, CA 92324 Phone: 909-514-1958
Sandra Hernandez-chavez, LMFT Counselor Medicare: Not Enrolled in Medicare Practice Location: 1461 E Cooley Dr Ste 100, Colton, CA 92324 Phone: 877-527-7227
Alexandria Lopez, Counselor Medicare: Not Enrolled in Medicare Practice Location: 23950 Prado Ln, Colton, CA 92324 Phone: 909-514-1958

Dr Clarence Carl Wilson, DBH, LPCC - Medicare Counselor in Colton, CA