Clayton Connelly, LPC in Fort Smith, AR - Medicare Counselor Provider

Clayton Connelly, LPC is a medicare enrolled "Counselor - Professional" provider in Fort Smith, Arkansas. His current practice location is 3111 S 70th St, Fort Smith, Arkansas. You can reach out to his office (for appointments etc.) via phone at (479) 452-6650.

Clayton Connelly is licensed to practice in Arkansas (license number P1607064) 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 1093091167.

Contact Information

	Clayton Connelly, LPC
	3111 S 70th St, Fort Smith, AR 72903-5017
	(479) 452-6650
	(479) 452-5847

Map and Direction

Healthcare Provider's Profile

Full Name	Clayton Connelly
Gender	Male
Speciality	Counselor - Professional
Location	3111 S 70th St, Fort Smith, Arkansas
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1093091167
Provider Enumeration Date: 11/02/2011
Last Update Date: 08/02/2016

Medicare PECOS Information:

PECOS PAC ID: 1456702257
Enrollment ID: I20240429002011

Medical Identifiers

Medical identifiers for Clayton Connelly such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1093091167	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
101YP2500X	Counselor - Professional	P1607064 (Arkansas)	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. Clayton Connelly allows following entities to bill medicare on his behalf.

Entity Name	Grow Healthcare Group Pa
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1245845932 PECOS PAC ID: 3476961368 Enrollment ID: O20210414000053

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. Clayton Connelly 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
Clayton Connelly, LPC Po Box 11818, Fort Smith, AR 72917-1818 Ph: (479) 452-6650	Clayton Connelly, LPC 3111 S 70th St, Fort Smith, AR 72903-5017 Ph: (479) 452-6650

Reviews and Comments

Counselor in Fort Smith, AR

Kylia Eastman, CIT Counselor Medicare: Not Enrolled in Medicare Practice Location: 3811 Rogers Ave, Fort Smith, AR 72903 Phone: 479-395-1599
Ms. Dinora Morales Reyes, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 3111 S 70th St, Fort Smith, AR 72903 Phone: 479-452-6650 Fax: 479-452-5847
Tochie K Benard, MHPP Counselor Medicare: Not Enrolled in Medicare Practice Location: 3111 S 70th St, Fort Smith, AR 72903 Phone: 479-452-6650 Fax: 479-452-5847
Julie Rae Moore, LCSW Counselor Medicare: Not Enrolled in Medicare Practice Location: 1340 S Waldron Rd, Fort Smith, AR 72903 Phone: 479-452-5040 Fax: 479-452-5047
Tabitha Fondren, Counselor Medicare: Not Enrolled in Medicare Practice Location: 3900 Armour Ave, Fort Smith, AR 72904 Phone: 479-783-8849 Fax: 479-783-1914
Miss Kylie Nicole Carroll, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 5401 Rogers Ave Ste 201, Fort Smith, AR 72903 Phone: 479-242-4560 Fax: 479-242-4561
Kasey Wilson, ADC, BA, QBHP Counselor Medicare: Not Enrolled in Medicare Practice Location: 3113 S 70th St, Fort Smith, AR 72903 Phone: 479-452-6650

Clayton Connelly, LPC - Medicare Counselor in Fort Smith, AR