Gracia Clark, in Maplewood, MN - Medicare Counselor Provider

Gracia Clark, is a medicare enrolled "Counselor" provider in Maplewood, Minnesota. Her current practice location is 2350 Stillwater Ave E Apt 202, Maplewood, Minnesota. You can reach out to her office (for appointments etc.) via phone at (920) 344-5779.

Gracia Clark is licensed to practice in Wisconsin (license number 8447125) 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 1417602251.

Contact Information

	Gracia Clark,
	2350 Stillwater Ave E Apt 202, Maplewood, MN 55119-3667
	(920) 344-5779
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Gracia Clark
Gender	Female
Speciality	Counselor
Location	2350 Stillwater Ave E Apt 202, Maplewood, Minnesota
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1417602251
Provider Enumeration Date: 02/21/2022
Last Update Date: 02/21/2022

Medicare PECOS Information:

PECOS PAC ID: 6103269592
Enrollment ID: I20240213003389

Medical Identifiers

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

Identifier	Type	State	Issuer
1417602251	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
101Y00000X	Counselor	8447125 (Wisconsin)	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. Gracia Clark allows following entities to bill medicare on her behalf.

Entity Name	Lakeview Memorial Hospital Association, Inc.
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1821114729 PECOS PAC ID: 1951210855 Enrollment ID: O20031104000543

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. Gracia 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
Gracia Clark, 2350 Stillwater Ave E Apt 202, Maplewood, MN 55119-3667 Ph: (920) 344-5779	Gracia Clark, 2350 Stillwater Ave E Apt 202, Maplewood, MN 55119-3667 Ph: (920) 344-5779

Reviews and Comments

Counselor in Maplewood, MN

Mr. Andrew A Johnson, BA BS MSW LICSW LADC Counselor Medicare: May Accept Medicare Assignments Practice Location: 981 Glendon St N, Maplewood, MN 55119 Phone: 612-354-9027
Mark Charles Lightner, B.A. Counselor Medicare: Not Enrolled in Medicare Practice Location: 2115 County Road D E # B, Maplewood, MN 55109 Phone: 651-748-5019 Fax: 651-773-7591
Cynthia Burgess, Counselor Medicare: Not Enrolled in Medicare Practice Location: 2103 County Road D E Ste B, Maplewood, MN 55109 Phone: 651-748-5019
Stephen Brennan, Counselor Medicare: Not Enrolled in Medicare Practice Location: 2000 White Bear Ave N, Maplewood, MN 55109 Phone: 612-235-4620
Khong Kaleb Mua, M.A. Counselor Medicare: Not Enrolled in Medicare Practice Location: 2115 County Road D E # B, Maplewood, MN 55109 Phone: 651-748-5019 Fax: 651-773-7591
Kiley Christine Krocak, Counselor Medicare: Not Enrolled in Medicare Practice Location: 2115 County Road D E, Suite B, Maplewood, MN 55109 Phone: 651-748-5019 Fax: 651-773-7591
Joel Lambrides, Counselor Medicare: Not Enrolled in Medicare Practice Location: 2103 County Road D E Ste B, Maplewood, MN 55109 Phone: 651-748-5019

Gracia Clark, - Medicare Counselor in Maplewood, MN