Ethan C Mandelkern, is a medicare enrolled "Social Worker - Clinical" provider in Mount Shasta, California. His current practice location is
419 Chestnut St, Suite #2, Mount Shasta, California. You can reach out to his office (for appointments etc.) via phone at
(530) 918-8348.
Ethan C Mandelkern is licensed to practice in California (license number LCSW64679) and he also participates in the medicare program. He
may accept medicare assignments (which means he may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance) and his NPI Number is 1023224623.
Healthcare Provider's Profile
| Full Name | Ethan C Mandelkern |
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| Gender | Male |
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| Speciality | |
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| Experience | Years |
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| Location | 419 Chestnut St, Mount Shasta, California |
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| Accepts Medicare Assignments | May be. He may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Ethan C Mandelkern attended and graduated from in
NPI Data:
- NPI Number: 1023224623
- Provider Enumeration Date: 05/14/2007
- Last Update Date: 08/12/2024
Medicare PECOS Information:
- PECOS PAC ID:
- Enrollment ID:
Medical Identifiers
Medical identifiers for Ethan C Mandelkern such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1023224623 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 101YP2500X | Counselor - Professional | LPCC726 (California) | Secondary |
| 1041C0700X | Social Worker - Clinical | LCSW64679 (California) | Primary |
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. Ethan C Mandelkern 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 |
|---|
Ethan C Mandelkern,
419 Chestnut St, Suite #2,
Mount Shasta, CA 96067-2918
Ph: (530) 918-8348 | Ethan C Mandelkern,
419 Chestnut St, Suite #2,
Mount Shasta, CA 96067-2918
Ph: (530) 918-8348 |
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