Jayson Clark, MSMFT, LPC in Roseburg, OR - Medicare Counselor Provider

Jayson Clark, MSMFT, LPC is a medicare enrolled "Counselor - Professional" provider in Roseburg, Oregon. His current practice location is 621 W Madrone St, Roseburg, Oregon. You can reach out to his office (for appointments etc.) via phone at (541) 672-2691.

Jayson Clark is licensed to practice in Oregon (license number C5596) 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 1598198954.

Contact Information

	Jayson Clark, MSMFT, LPC
	621 W Madrone St, Roseburg, OR 97470
	(541) 672-2691
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Jayson Clark
Gender	Male
Speciality	Counselor - Professional
Location	621 W Madrone St, Roseburg, Oregon
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1598198954
Provider Enumeration Date: 08/20/2013
Last Update Date: 07/07/2022

Medicare PECOS Information:

PECOS PAC ID: 0345692307
Enrollment ID: I20240116002356

Medical Identifiers

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

Identifier	Type	State	Issuer
1598198954	NPI	-	NPPES
500725582	Medicaid	OR
500714629	Medicaid	OR

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
101YA0400X	Counselor - Addiction (substance Use Disorder)	T-17-081 (Oregon)	Secondary
101YM0800X	Counselor - Mental Health	(* (Not Available))	Secondary
101YP2500X	Counselor - Professional	C5596 (Oregon)	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. Jayson Clark allows following entities to bill medicare on his behalf.

Entity Name	Adapt
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1720010549 PECOS PAC ID: 4587662887 Enrollment ID: O20061121000327

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. Jayson 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
Jayson Clark, MSMFT, LPC Po Box 1121, Roseburg, OR 97470-0254 Ph: () -	Jayson Clark, MSMFT, LPC 621 W Madrone St, Roseburg, OR 97470 Ph: (541) 672-2691

Reviews and Comments

Counselor in Roseburg, OR

Hanna Rae Culbertson, LCSW Counselor Medicare: Not Enrolled in Medicare Practice Location: 3031 Ne Stephens St, Roseburg, OR 97470 Phone: 541-229-7089 Fax: 541-229-9908
Elisabeth Erin Payne, Counselor Medicare: Not Enrolled in Medicare Practice Location: 215 Se Jackson St, Roseburg, OR 97470 Phone: 541-464-6660
Mr. Dale Edward Williams, MC, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 621 W Madrone St, Roseburg, OR 97470 Phone: 541-440-3532 Fax: 541-440-3554
Inger C Boyd, MA ED., BS Counselor Medicare: Not Enrolled in Medicare Practice Location: 621 W Madrone St, Roseburg, OR 97470 Phone: 541-440-3532 Fax: 541-440-3554
Mae L Hoopes, Counselor Medicare: Not Enrolled in Medicare Practice Location: 621 W Madrone St, Roseburg, OR 97470 Phone: 541-672-2691 Fax: 541-673-5642
Sarah Rebecca Jo Moon, Counselor Medicare: Not Enrolled in Medicare Practice Location: 3099 Ne Diamond Lake Blvd, Roseburg, OR 97470 Phone: 541-672-2691
Lois Francis-wolf, Counselor Medicare: Not Enrolled in Medicare Practice Location: 2700 Nw Stewart Pkwy, Annex A, Roseburg, OR 97471 Phone: 541-672-5667 Fax: 541-672-1048

Jayson Clark, MSMFT, LPC - Medicare Counselor in Roseburg, OR