Ethan C Mandelkern, is a medicare enrolled "Social Worker - Clinical" provider in Mount Shasta, California. He graduated from healthcare school in 2006 and has 18 years of diverse experience with area of expertise as Clinical Social Worker. 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 | Clinical Social Worker |
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| Experience | 18 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 graduated from medical school in 2006
NPI Data:
- NPI Number: 1023224623
- Provider Enumeration Date: 05/14/2007
- Last Update Date: 08/12/2024
Medicare PECOS Information:
- PECOS PAC ID: 6204137771
- Enrollment ID: I20151229001508
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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